Fang Jincheng, Liu Quan, Wu Chuangyan, Li Jinsong
Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, Hubei, China.
J Surg Case Rep. 2024 Oct 13;2024(10):rjae620. doi: 10.1093/jscr/rjae620. eCollection 2024 Oct.
We report a case of massive chest wall bleeding after lung wedge resection caused by a protruding staple. On the third postoperative day, the patient experienced sudden left posterior back pain without any apparent trigger, accompanied by signs of shock. Computed tomography imaging revealed a significant accumulation of blood in the pleural cavity on the side of the surgery. A reoperation was performed, during which we identified active arterial bleeding from a small vessel at the second intercostal space on the posterior chest wall. Hemostasis was achieved using electrocautery. Further examination revealed a protruding staple at the left upper lobe resection margin, which we speculated was likely causing abrasion against the chest wall and leading to the bleeding. This case reveals the potential risk posed by protruding staples. Appropriate precautions should be taken to prevent this rare but dangerous occurrence.
我们报告一例因吻合钉突出导致肺楔形切除术后胸壁大量出血的病例。术后第三天,患者无明显诱因突然出现左后背疼痛,并伴有休克体征。计算机断层扫描成像显示手术侧胸腔内有大量血液积聚。遂进行再次手术,术中我们发现后胸壁第二肋间的一小血管有活动性动脉出血,用电灼法止血。进一步检查发现左上叶切除边缘有一枚突出的吻合钉,我们推测这可能是导致胸壁磨损并引起出血的原因。本病例揭示了突出吻合钉带来的潜在风险。应采取适当预防措施以防止这种罕见但危险的情况发生。