Intrapleural fibrinolysis in clotted haemothorax

Agarwal R, Aggarwal AN, Gupta D
Correspondence: Dr Ritesh Agarwal, riteshpgi@gmail.com

ABSTRACT
The immediate treatment of haemothorax is thoracostomy tube insertion. One complication of haemothorax is retained blood and if improperly managed, this can lead to complications such as empyema and fibrothorax. The ideal management of clotted haemothorax is a matter of controversy. Video-assisted thoracoscopic surgery (VATS) is believed to be the best available modality for the management of clotted haemothorax. However, VATS is not routinely available in many centres. One easily available and effective alternative to VATS is the use of intrapleural fibrinolysis. We report the successful management of a post-traumatic clotted haemaothorax in a 34-year-old man, using intrapleural instillation of streptokinase, and review the literature on the management of clotted haemothorax.

Keywords: clotted haemothorax, haemothorax, intrapleural fibrinolysis, intrapleural streptokinase, video-assisted thoracoscopic surgery
Singapore Med J 2006; 47(11): 984-986