Abstract

A spontaneous hemopneumothorax (SHP) has been defined as the accumulation of at least 400 mL of blood in the pleural cavity in association with a spontaneous pneumothorax. The incidence of SHP has been reported to be around 1-12% of all spontaneous pneumothorax cases and is found most commonly in men of 20–60 years of age during the first episode of pneumothorax. The most frequent presenting symptoms are chest pain and sudden dyspnea. Although their initial clinical manifestations may be very similar, the potential development of hypovolemic shock leading to rapid clinical deterioration distinguishes SHP from spontaneous pneumothorax. This report presents a unique pediatric case of a 17-year-old that presented to the emergency department with right sided chest pain and shortness of breath for 3 days. Radiographic imaging studies and computed tomography of the chest confirmed a right sided hemopneumothorax. The patient was treated with tube thoracostomy and video-assisted thoracoscopic surgery (VATS). No pathological etiology for the SHP was discovered after extensive work up and patient was discharged.