The patient, male, 29 years old, was admitted to the emergency room with sudden onset of chest pain for 8 hours with dizziness, no fever, no cough. Physical examination on admission: clear and tired, pale, painful face, low blood pressure, 90/56 mmHg, heart rate 80 beats/min, oxygen saturation SPO2
99%; right lung breath sounds were diminished, chest radiograph suggested right liquid pneumothorax, right lung compression 40%, medium amount of pleural effusion. Considering the possibility of acute hemopneumothorax, the patient was immediately expanded to correct shock and sent to the operating room for urgent thoracoscopic exploration to stop bleeding and resection of pulmonary bullae, during the operation, multiple pulmonary bullae were seen at the right lung apex, a small artery at the right thoracic apex was dissected with pulsatile bleeding, and a large amount of dark red blood clots and bloody pleural fluid had accumulated in the thoracic cavity, totaling 2000 ml. The operation was successful and the patient was discharged 3 days after the operation.