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左上肺叶切除术后脾梗死:病例报告。

Splenic infarction after left upper lobectomy: a report of a case.

机构信息

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Yahatanishi, Kitakyushu, 807, Japan.

出版信息

Gen Thorac Cardiovasc Surg. 2021 Nov;69(11):1506-1510. doi: 10.1007/s11748-021-01691-5. Epub 2021 Aug 18.

Abstract

We report the case of a 70-year-old man who developed a splenic infarction due to a thrombus in the pulmonary vein (PV) stump after left upper lobectomy (LUL). Preoperative imaging showed a mass measuring > 5 cm in the upper lobe of the left lung, and sputum cytology revealed squamous cell carcinoma. Therefore, video-assisted thoracoscopic LUL was performed. The postoperative course was uneventful but biochemical blood tests showed an increased inflammatory response. Contrast-enhanced computed tomography revealed splenic infarction and a thrombus in the left superior PV stump. Prompt treatment with anticoagulants was administered, and the patient was discharged with mild recovery. However, the patient developed cerebral infarction after discharge and died 33 days after the surgery. Splenic infarction is a rare postoperative complication, with only three reported cases, including this report. However, this condition should be considered along with PV thrombus when evaluating an increased inflammatory response after LUL.

摘要

我们报告了一例 70 岁男性患者,因左上肺叶切除术(LUL)后肺静脉(PV)残端血栓形成而发生脾梗死。术前影像学检查显示左肺上叶有一个>5cm 的肿块,痰细胞学检查显示为鳞状细胞癌。因此,行电视辅助胸腔镜 LUL。术后过程顺利,但生化血液检查显示炎症反应增加。增强 CT 显示脾梗死和左肺上 PV 残端血栓形成。立即给予抗凝治疗,患者轻度恢复后出院。然而,患者出院后发生脑梗死,术后 33 天死亡。脾梗死是一种罕见的术后并发症,仅有三例报告,包括本报告。然而,在评估 LUL 后炎症反应增加时,应将这种情况与 PV 血栓一起考虑。

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