Spontaneous hemopneumothorax with massive bleeding is considered a rare complication of spontaneous pneumothorax. The authors describe two patients with acute chest pain and dyspnea; the chest X-ray showed pneumothorax and pleural effusion. The two cases were submitted to thoracic drainage and presented important bleeding; thoracotomy was performed and in the first case an aberrant vessel was found, and in the second case the source of bleeding was rupture of pleural adherence. The post-operative evolution had no incidents in either case.

Keywords: Pneumothorax. Hemopneumothorax. Spontaneous rupture.