ABSTRACT
PURPOSE OF REVIEW: Spontaneous hemopneumothorax can be life threatening, and is a cause of patients presenting with unexplained signs of significant hypovolemia. The debate relating to patient selection and timing of surgery in patients with spontaneous hemopneumothorax remains unresolved. RECENT FINDINGS: Our experience together with the latest series published over the last decade on the conservative and surgical management of spontaneous hemopneumothorax are presented and discussed. SUMMARY: Surgery should be performed early in the management of spontaneous hemopneumothorax to reduce morbidity. In particular, video-assisted thoracic surgery, which is associated with potentially fewer post-operative complications and shorter hospital stays compared with thoracotomy, should be considered in patients with spontaneous hemopneumothorax who are hemodynamically stable.