Massive hemopneumothorax after traditional massage: a case report

Introduction: Hemothorax is defined as an accumulation of blood, whereas pneumothorax is defined as the presence of air, in the pleural cavity. This case report presents hemopneumothorax as the aftermath of thoracic trauma from traditional body massage, which is a common practice in Indonesia. Case presentation: A 31-year-old male was referred due to dyspnea a day after getting a traditional whole-body massage. Thoracocentesis and chest tube insertion were performed. The production of blood was massive, causing the patient to deteriorate. Emergency thoracotomy exploration was performed to stop the bleeding and evacuate the hematoma. Eventually, the patient had an uneventful recovery. Discussion: In this case, the force of massage in the thorax area causes rupture of a pre-existing bullae, causing hemopneumothorax, which causes a life-threatening consequence. Early diagnosis and prompt treatment are essential. Conclusion: External pressure force can lead to the rupture of a pre-existing bullae or bleb, resulting in hemopneumothorax. This case of novel hemopneumothorax should increase awareness to healthcare providers and the public about the adverse effect of overly intense body massage.