Hemopneumothorax After Carotid Endarterectomy

Spontaneous hemopneumothorax (SHP) is a rare condition characterized by the accumulation of air and blood in the pleural cavity without prior trauma. We present a case of a patient who underwent carotid endarterectomy for carotid artery stenosis. Two days postoperatively, she developed sudden respiratory distress, hypotension, tachycardia, and a decrease in hemoglobin levels. A chest X‐ray revealed a massive left‐sided hemopneumothorax. A chest tube was inserted, but no active bleeding source was identified on subsequent imaging. Despite initial stabilization, the patient required intubation and underwent video‐assisted thoracoscopic surgery for residual hemothorax and empyema. She fully recovered. In this case report, we provide an overview of the diagnostic and treatment options for SHP. As SHP is a potentially life‐threatening condition, we emphasize the importance of including it in the differential diagnosis of sudden patient deterioration. In our case, the patient had undergone vascular surgery; however, the cause of hemorrhagic shock was unexpectedly SHP.