Visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy
| Autor: | Nobuhito Ueda, Hirofumi Adachi, Yasushi Mizukami, Jun Arikura |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Segmentectomy medicine.medical_specialty Lung Neoplasms Deep vein Diaphragm lcsh:Surgery Diaphragmatic breathing Case Report Adenocarcinoma of Lung Adenocarcinoma Postoperative Hemorrhage Lung resection lcsh:RD78.3-87.3 03 medical and health sciences Visceral subpleural hematoma 0302 clinical medicine Hematoma medicine Humans Pneumonectomy Abscess Aged Lung Thoracic Surgery Video-Assisted business.industry Vats General Medicine lcsh:RD1-811 Pleural Diseases medicine.disease Thrombosis Surgery Cardiac surgery medicine.anatomical_structure 030228 respiratory system Cardiothoracic surgery lcsh:Anesthesiology 030220 oncology & carcinogenesis Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic Surgery, Vol 12, Iss 1, Pp 1-5 (2017) Journal of Cardiothoracic Surgery |
| ISSN: | 1749-8090 |
| DOI: | 10.1186/s13019-017-0657-6 |
| Popis: | Background Pulmonary visceral subpleural hematoma is rare. We report visceral subpleural hematoma of the left diaphragmatic surface following left upper division segmentectomy. This very rare case was difficult to distinguish from thoracic abscess. Case presentation A 68-year-old man with hypertension had undergone video-assisted thoracoscopic left upper division segmentectomy for suspected lung carcinoma. Deep vein thrombosis of the lower leg was identified and edoxaban, a so-called novel oral anticoagulant, was started on postoperative day 7. The chest drainage tube was removed on postoperative day 12 because of persistent air leakage, but fever appeared the same day. Computed tomography revealed a cavity with mixed air and fluid, so antibiotics were started on suspicion of abscess. Computed tomography-guided drainage was attempted, but proved unsuccessful. Fever continued and surgical investigation was therefore performed. Visceral subpleural hematoma was identified under the diaphragmatic surface of the left basal lung. We excised the pleura, then performed drainage and applied running sutures. The parenchyma and visceral pleura were covered with polyglycolic acid sheet and fibrin glue. Edoxaban was restarted on postoperative day 12 of video-assisted thoracoscopic surgery and no recurrence of hematoma has been revealed. Conclusions Visceral subpleural hematoma after thoracic surgery is extremely rare. Furthermore, correct diagnosis was difficult and surgery offered a good diagnostic and therapeutic procedure. |
| Databáze: | OpenAIRE |
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