[Spontaneous hemopneumothorax treated with video-assisted thoracoscopic surgery; report of two cases].

Case 1: A 41-year-old man developed right chest pain. Computed tomography (CT) revealed right tension hemopneumothorax. Chest tube was placed in the pleral cavity immediately. Because of continuous bleeding and inadequate lung expansion, video-assisted thoracic surgery (VATS) was performed on day 11 afer admission. Thoracoscopic view clearly showed bleeding point at the thoracic apex. Hemostasis was performed and peel was removed for expansion of lung. Case 2: A 38-year-old man developed right chest pain and dyspnea. CT revealed right hemopneumothorax. Because of massive continuous bleeding, emergent VATS was performed. Thoracoscopic view clearly showed bleeding point at the thoracic apex and the hemostasis and the resection of bullae was performed. Postoperative course of both cases was uneventful. It is thought to be important to consider early surgical approach for hemopneumothorax to identify the cause of airleakage before forming thick peel on the visceral pleura.