Waqanivavalagi Steve W F R, Chaudhuri Krish
Green Lane Cardiothoracic Surgical Unit, Auckland City Hospital, Auckland District Health Board, Auckland, New Zealand.
J Surg Case Rep. 2021 Mar 13;2021(3):rjab049. doi: 10.1093/jscr/rjab049. eCollection 2021 Mar.
Retention of an intercostal drain segment is an uncommon and infrequently reported complication of underwater seal drain use. We report the case of a 66-year-old New Zealand European male who underwent bilateral lung transplantation for severe chronic obstructive pulmonary disease and bronchiectasis. The patient required a return to the operating room for exploratory surgery after an intercostal drain severed during its attempted removal and became retained within the chest cavity. A deep suture had inadvertently been passed around the chest drain intraoperatively. In the event of such a complication, prompt recognition and removal of the retained segment is required. This novel case is reported to highlight the possibility of an entrapped suture as a cause of resistance when attempting to remove an intercostal drain. Kinking on a chest X-ray may also point to this problem, and senior input should be sought early if radiographic findings are coupled with clinical difficulties.
保留一段肋间引流管是水封引流使用中一种罕见且鲜有报道的并发症。我们报告一例66岁的新西兰欧洲男性病例，该患者因严重慢性阻塞性肺疾病和支气管扩张接受了双侧肺移植。在试图拔除肋间引流管时引流管断裂并残留在胸腔内，患者需要返回手术室进行探查手术。术中不慎在胸腔引流管周围缝了一道深缝线。发生这种并发症时，需要及时识别并取出残留段。报告这一罕见病例是为了强调在试图拔除肋间引流管时，缝线嵌顿可能是导致阻力的原因。胸部X光片上的扭结也可能提示这个问题，如果影像学检查结果与临床困难同时出现，应尽早寻求上级医生的指导。
