44 year old patient with ovarian carcinoma. In the immediate postoperative period, there was gradual development of tachycardia and hypotension with severe reduction in red blood cell count.
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There is air in right pleural cavity (pneumothorax) with massive pleural effusion with density of blood, also with clotted blood in basal regions. Midline structures are pushed to the left. Pnemoperitoneum is also present.
The patient underwent hysterectomy, bilateral adnexectomy, omentectomy, diaphragmatic resection and lymphadenectomy.
After suspected haemoperitoneum, no signs of abdominal bleeding were found. CT confirmed haemopneumothorax, which was successfully treated with blood substitutes, active drainage and VATS. Altogether 2200 mL of blood was drained.