Intrapleural tranexamic acid in persistent malignant hemothorax: a case report

Abstract

Hemothorax occurs due to various conditions such as trauma, malignancy, tuberculosis, bullous lung disease, and lung abscess. In patients with malignant hemothorax, stabilization of the clinical condition and treatment of primary disease is of primary importance. A 53-year-old female patient, who had a history of surgery for ovarian cancer and liver metastasis, admitted to the hospital with complaints of shortness of breath. The patient was found to have pleural effusion on the right hemithorax, and a tube thoracostomy was performed. During the clinical follow-up, the amount of drainage did not decrease. Thereby, the patient underwent a video-thoracoscopic evaluation, and chemical pleurodesis was applied intraoperatively. Despite chemical pleurodesis, hemorrhagic drainage continued. Intrapleural tranexamic acid administration was performed to ensure the stabilization of the clinical condition. Immediately days after the intrapleural application of tranexamic acid, the drainage of the fluid decreased and became sero-hemorrhagic. The management of this case made us think that intrapleural tranexamic acid may be an alternative in persistent malign hemothorax.