Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Ann Thorac Cardiovasc Surg. 2024;30(1). doi: 10.5761/atcs.cr.24.00121.
Chronic expanding hematoma (CEH) is defined as a hematoma that gradually expands over months to years. An 82-year-old female underwent proton radiotherapy for left upper lobe lung cancer 10 years previously. Two years after the therapy, a hematoma developed from the left 3rd to 5th dorsal rib fractures and gradually expanded, causing contraction of the left shoulder. Transcatheter arterial embolization was performed; however, the hematoma continued to expand with thrombocytopenia, and the platelet was decreased to 4.2 × 10/μL. Computed tomography showed a 17.2 × 14.0 × 10.0 cm mass between the left scapula and left dorsal ribs. The CEH of the thorax was completely excised with combined resection of the 3rd to 5th ribs, while the brachial plexus was preserved. Postoperatively, the platelet completely recovered and she could raise her left arm. A complete excision with surrounding organs preserved is the strategy used in the treatment of CEH of the thorax.
慢性扩展血肿（CEH）定义为血肿在数月至数年内逐渐扩大。一名 82 岁女性 10 年前因左上肺肺癌接受质子放疗。治疗后 2 年，左第 3 至 5 肋骨骨折处出现血肿并逐渐扩大，导致左肩收缩。进行了经导管动脉栓塞术；然而，随着血小板减少症，血肿继续扩大，血小板降至 4.2×10/μL。计算机断层扫描显示左肩胛骨和左背肋骨之间有一个 17.2×14.0×10.0cm 的肿块。胸部的 CEH 与第 3 至 5 肋骨的联合切除术一起完全切除，同时保留臂丛神经。术后，血小板完全恢复，她可以抬起左臂。保留周围器官的完全切除是治疗胸部 CEH 的策略。
