A case of an extrapleural hematoma that caused late-onset pleural effusion

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We encountered a rare case of extrapleural hematoma which developed into late-onset pleural effusion. The patient was a 52-year-old male. On admission to our hospital, we diagnosed him with traumatic hemothorax, and conducted chest tube drainage. The amount of drainage decreased rapidly (50 ml/day), and so the patient was extubated and discharged from the hospital. After one week, the patient presented with a noticeable increase of pleural effusion, for which we conducted chest tube drainage again.To identify the cause of the recurrent pleural effusion, we conducted VATS (video-assisted thoracoscopic surgery). We noted that a part of the parietal pleura was torn and a dark red liquid was flowing into the thoracic cavity from the tear. It was thought that a hematoma had formed outside the parietal pleura, and hemolysate from the hematoma flowed into the thoracic cavity, causing recurrent pleural effusion. The current case suggests that VATS may be a useful option in diagnosing and treating patients with extrapleural hematomas.