Kameda Yohei, Osawa Hiroyuki, Sueishi Yui, Ishikawa Yoshihiro, Maehara Takamitsu
Department of Thoracic Surgery, Yokohama Minami Kyosai Hospital, 1-21-1, Mutsuurahigashi, Kanazawa-ku, Yokohama 236-0037, Kanagawa, Japan.
Department of General Thoracic Surgery, Yokohama City University Hospital, 3-9, Fukuura, Kanazawa-ku, Yokohama 236-0004, Kanagawa, Japan.
J Surg Case Rep. 2024 May 12;2024(5):rjae271. doi: 10.1093/jscr/rjae271. eCollection 2024 May.
We report a case of delayed bleeding after video-assisted thoracic surgery (VATS) that was successfully treated with transcatheter arterial embolization. An 81-year-old woman underwent a pleural biopsy via VATS for pleural dissemination of lung cancer. The postoperative course was good, but 8 days later she was hospitalized for swelling in the right axilla and was admitted to our hospital with a diagnosis of delayed postoperative hemorrhage. Gauze compression was performed, and the patient was discharged without exacerbation of hematoma. However, 4 days later, she was hospitalized for rapidly worsening swelling and pain. Chest computed tomography at the time of rebleeding showed an increase in the hematoma and extravasation in the peripheral right lateral thoracic artery. The patient was immediately treated with emergency angiography, and coil embolization was performed. After this treatment, the patient has done well and there has been no subsequent recurrence of bleeding.
我们报告一例电视辅助胸腔镜手术(VATS)后延迟出血的病例,该病例通过经导管动脉栓塞术成功治疗。一名81岁女性因肺癌胸膜播散接受了VATS胸膜活检。术后过程顺利,但8天后因右腋窝肿胀住院,诊断为术后延迟出血而入住我院。进行了纱布压迫,患者出院时血肿未加重。然而,4天后,她因肿胀和疼痛迅速加重再次住院。再次出血时的胸部计算机断层扫描显示血肿增大,右侧胸外侧动脉外周有造影剂外渗。患者立即接受了急诊血管造影,并进行了弹簧圈栓塞术。经过该治疗后,患者情况良好,后续未再发生出血。