Spontaneous hemothorax is uncommon. Known causes include tumor, anticoagulant therapy, arteriovenous malformations, pulmonary emboli, and tuberculosis. Spontaneous hemothorax is usually associated with spontaneous pneumothorax, although it may be isolated.1
Massive bleeding is rare. The case presented here shows two unusual features. The bleeding was severe enough to produce mediastinal shift and compression of the opposite lung. The hemothorax was associated with minimal pneumothorax on admission and with no air leak.
Report of a Case.—On Jan 13, 1976, a 23-year-old man began to have left pleuritic chest pain. He became fatigued, lightheaded, and short of breath. He came to the Chest roentgenogram taken in supine position on initial appearance in emergency department. Trachea and mediastinum were forced over by massive hemothorax on left side. There is a small amount of air noticeable in left lower chest but almost entire chest is occupied by blood.
Emergency Department of Colorado General