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Hemothorax Complicating Thoracentesis

Hemothorax Complicating Thoracentesis▶ Watch on YouTube — age-restricted, cannot embed here

Imaging findings

Serial chest radiographs in two separate patients demonstrate the rapid and dramatic accumulation of massive pleural fluid (completely opacifying a hemithorax) within hours following diagnostic thoracentesis. In both cases, the pleural fluid was surgically proven to be a large acute hemothorax.

Key takeaways

While diagnostic and therapeutic thoracentesis is generally a safe procedure, it carries a small risk of severe complications, including acute hemothorax. Hemothorax typically results from a laceration of an intercostal vessel or a direct lung laceration during the procedure, and can lead to rapid hemorrhagic shock and the need for emergent surgical intervention.

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