The “May Day” holiday in Yangcheng staged a romantic and thrilling story of online love not thousands of miles to go to Yangcheng dating online friends to see their girlfriends too beautiful actually shocked on the spot. A university of technology in Anhui Fang students, two years ago on the network met a female Internet friend who lives in Guangzhou, the two talked a lot, to the beginning of this year, developed into an online relationship. The first of May holiday, Fang could not wait to come to Guangzhou, and online girlfriend to meet. I did not think that the girlfriend than the photo on the more beautiful, surprise over when collapsed in a coma, life critical. After being taken to the hospital, through the film found that the right side of the chest cavity has a large amount of pneumonia and fluid, that is, the occurrence of hemopneumothorax. The doctor immediately released the tube to vent the fluid, at that time discharged 2000 ml of blood. The next day, Fang still did not improve, the doctors took another open-chest blood surgery, found that there are 3000 ml of blood and blood clots in the chest cavity, and the blood vessels in the chest is still bubbling blood, after a series of treatment such as blood and fluid, the patient was in a coma for nearly 9 hours before waking up, before and after a total of bleeding reached 5000 ml. Physician comments: The blood volume of the human body is about 7-8% of body weight, the blood volume of a person weighing 60 kg is about 4000-5000 ml, of which some blood remains in the liver and spleen and other blood storage organs, if the acute blood loss of 30% (i.e. 1200 ml) or more, it may be life-threatening due to hemorrhagic shock. In the news, Fang lost 5000 ml of blood, almost losing all the blood in his body, without timely replenishment, his life will not be saved. Therefore, it should be possible to bleed slowly successively and be replenished by blood and fluid transfusion in the hospital. Fang’s hemopneumothorax is medically called spontaneous hemopneumothorax, to distinguish it from the hemopneumothorax caused by trauma. Pneumothorax means that the chest cavity contains only gas, while hemothorax is the accumulation of blood in the chest cavity, and hemopneumothorax is the co-existence of both. Spontaneous hemopneumothorax usually does not have underlying lesions such as tuberculosis and emphysema, and is more common in adolescents at the age of illness. Most of them appear after forceful weight-bearing, violent coughing and breath-holding, and a few patients have no obvious cause. It is rare to see a hemopneumothorax like Fang’s due to the surprise of seeing a celestial being at first sight. Generally speaking, patients with spontaneous hemopneumothorax mostly have congenital defects in the development of lung structures, and some alveolar walls are weak, forming large alveoli under the action of inhalation air pressure. Just like a balloon if its wall thickness is not uniform, when you blow the balloon hard, the weak part will be inflated outward. In some patients, the lung adheres to the inner wall of the pleural cavity to form an adhesion zone, which may contain small arterial vessels. The pulmonary alveoli and adhesive bands are mostly located in the apical part of the lung. When the alveoli rupture due to a sudden rise in intrapulmonary pressure, gas enters the pleural cavity through the fissure, which can cause spontaneous pneumothorax; when the lung compression is caused, the adhesion zone can be stretched, causing the adhesion zone to tear, and the small arteries in the adhesion zone can rupture and bleed, resulting in spontaneous hemothorax. Because the vessels in the adhesion zone are mostly connected with the body circulation, the pressure is high, and the pressure in the pleural cavity is low, and the vessels in the adhesion zone are not easy to contract. Therefore, the bleeding is often not easy to stop by itself and can cause continuous bleeding, resulting in the accumulation of blood in the patient’s chest cavity, and the patient can have different degrees of internal bleeding signs. Small amount of hemothorax, bleeding volume below 500 ml, the patient may have no obvious symptoms, chest X-ray examination only shows the disappearance of the rib diaphragm angle. In medium-volume hemothorax (bleeding volume of 500~1000ml) and large-volume hemothorax (bleeding volume of 1000ml or more), especially when acute blood loss occurs, the patient may have pale face, cold sweat, rapid pulse, chest tightness, shortness of breath, dyspnea and other discomforts. Due to the sudden decrease in circulating blood volume, the patient may even experience hypovolemic shock symptoms such as a drop in blood pressure. In addition, hemothorax with medium or higher volume can cause respiratory dysfunction due to the accumulation of blood in the chest cavity and compression of the lungs, which can affect the ventilation function, while the large amount of bleeding in the pleural cavity can compress the mediastinum and displace it, causing obstruction of blood return and aggravating the circulatory dysfunction. If not rescued in time, it can be life-threatening. Fang was probably in a state of extreme excitement, with rapid heartbeat and shortness of breath, resulting in a sudden rise in intrapulmonary pressure causing alveolar rupture and hemopneumothorax. The fact that Fang’s life was saved should be attributed to the timely rescue. The treatment of spontaneous hemopneumothorax should depend on the amount of bleeding and whether it is progressive or not. Generally speaking, a small amount of spontaneous hemothorax can be absorbed naturally without puncture and fluid extraction, but the changes in pulse, respiration and blood pressure should be closely observed and recorded, changes in clinical symptoms and signs should be noted, and chest X-ray chest films should be reviewed when necessary. In order to prevent secondary infection of pleural cavity blood accumulation, antibiotic treatment should be routinely given. If the amount of accumulated blood is large, pleural cavity puncture should be performed as early as possible to extract the accumulated blood and promote lung expansion to improve respiratory function. Or place closed chest drainage, which can drain the blood more effectively, prevent infection and the occurrence of “coagulative hemothorax”, facilitate lung reopening, and help determine whether there is progressive bleeding. If clinical observation determines that the patient’s condition continues to deteriorate, shock symptoms gradually worsen, and there is progressive bleeding in the chest cavity, emergency thoracotomy should be performed decisively to stop the bleeding while actively resisting shock and transfusing whole blood. If the patient has recurrent spontaneous hemopneumothorax, the persistence of pulmonary herpes or adhesive band should be considered, and the patient should be kept in the hospital for pulmonary herpes or adhesive band excision. Currently, the common surgical methods include conventional open-heart surgery or minimally invasive thoracoscopic resection of pulmonary blisters. If the cause of spontaneous hemopneumothorax is not eradicated, there is a possibility of recurrent attacks, so attention should be paid to prevention in general. Patients should try to avoid engaging in weight-bearing or strenuous sports activities such as weight lifting, diving, intense rivalry games, etc. In daily life, if you suddenly feel chest tightness, shortness of breath, dyspnea, increased pulse rate, pale face, cold sweat and other discomforts, you should seek medical attention in time to avoid delaying the condition and leading to serious consequences.