Extrapleural haematoma

Extrapleural haematoma (EPH) is a rare situation, which usually occurs due to rib fracture or blunt chest injury.

EPH results from accumulation of blood in the extrapleural space where the overlying extrapleural fat is displaced centrally.

  • common: injury to intercostal arteries or veins
  • less common: from other vessels such as aortic rupture, penetrating trauma and/or iatrogenic injury

When located laterally, an extrapleural haematoma may cause the typical peripheral pleural opacity which has smooth borders with the pleura without acute angles. When anterior or posterior, the frontal X ray will just show non specific opacification.

May show a focal extrapleural collection in the appropriate clinical context with an extrapleural fat sign. They may be biconvex or nonconvex, with the former being larger.

Biconvex EPHs more often require surgical intervention, while non-convex haematomas are usually be managed conservatively 4.

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Article information

rID: 41797
Systems: Chest, Trauma
Section: Pathology
Tags: trauma, cases
Synonyms or Alternate Spellings:
  • Extrapleural haematomas
  • Extra-pleural haematoma
  • Extrapleural hematoma
  • Extrapleural hematomas

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Cases and figures

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    Case 1: probable on right
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    Case 2: on CT with rib fractures
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