Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax

Severe intrathoracic hemorrhage from pulmonary parenchyma is the most serious complication of pulmonary laceration after blunt trauma requiring immediate surgical hemostasis through open thoracotomy. The safety and efficacy of video-assisted thoracoscopic surgery (VATS) techniques for this life-thre...

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Main Authors: Hideki Ota, Hideki Kawai, Shuntaro Togashi, Tsubasa Matsuo
Format: Article
Language:English
Published: Hindawi Limited 2014-01-01
Series:Case Reports in Emergency Medicine
Online Access:http://dx.doi.org/10.1155/2014/454970
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spelling doaj-e1c453f691044666b0a0c685c08b74302020-11-24T22:28:07ZengHindawi LimitedCase Reports in Emergency Medicine2090-648X2090-64982014-01-01201410.1155/2014/454970454970Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive HemothoraxHideki Ota0Hideki Kawai1Shuntaro Togashi2Tsubasa Matsuo3Department of Thoracic Surgery, Akita Red Cross Hospital, 222-1 Kamikitate, Akita City, Akita 010-1495, JapanDepartment of Thoracic Surgery, Akita Red Cross Hospital, 222-1 Kamikitate, Akita City, Akita 010-1495, JapanDepartment of Thoracic Surgery, Akita Red Cross Hospital, 222-1 Kamikitate, Akita City, Akita 010-1495, JapanDepartment of Thoracic Surgery, Akita Red Cross Hospital, 222-1 Kamikitate, Akita City, Akita 010-1495, JapanSevere intrathoracic hemorrhage from pulmonary parenchyma is the most serious complication of pulmonary laceration after blunt trauma requiring immediate surgical hemostasis through open thoracotomy. The safety and efficacy of video-assisted thoracoscopic surgery (VATS) techniques for this life-threatening condition have not been fully evaluated yet. We report a case of pulmonary laceration with a massive hemothorax after blunt trauma successfully treated using a combination of muscle-sparing minithoracotomy with VATS techniques (video-assisted minithoracotomy). A 22-year-old man was transferred to our department after a falling accident. A diagnosis of right-sided pneumothorax was made on physical examination and urgent chest decompression was performed with a tube thoracostomy. Chest computed tomographic scan revealed pulmonary laceration with hematoma in the right lung. The pulmonary hematoma extending along segmental pulmonary artery in the helium of the middle lobe ruptured suddenly into the thoracic cavity, resulting in hemorrhagic shock on the fourth day after admission. Emergency right middle lobectomy was performed through video-assisted minithoracotomy. We used two cotton dissectors as a chopstick for achieving compression hemostasis during surgery. The patient recovered satisfactorily. Video-assisted minithoracotomy can be an alternative approach for the treatment of pulmonary lacerations with a massive hemothorax in hemodynamically unstable patients.http://dx.doi.org/10.1155/2014/454970
collection DOAJ
language English
format Article
sources DOAJ
author Hideki Ota
Hideki Kawai
Shuntaro Togashi
Tsubasa Matsuo
spellingShingle Hideki Ota
Hideki Kawai
Shuntaro Togashi
Tsubasa Matsuo
Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
Case Reports in Emergency Medicine
author_facet Hideki Ota
Hideki Kawai
Shuntaro Togashi
Tsubasa Matsuo
author_sort Hideki Ota
title Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
title_short Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
title_full Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
title_fullStr Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
title_full_unstemmed Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax
title_sort video-assisted minithoracotomy for pulmonary laceration with a massive hemothorax
publisher Hindawi Limited
series Case Reports in Emergency Medicine
issn 2090-648X
2090-6498
publishDate 2014-01-01
description Severe intrathoracic hemorrhage from pulmonary parenchyma is the most serious complication of pulmonary laceration after blunt trauma requiring immediate surgical hemostasis through open thoracotomy. The safety and efficacy of video-assisted thoracoscopic surgery (VATS) techniques for this life-threatening condition have not been fully evaluated yet. We report a case of pulmonary laceration with a massive hemothorax after blunt trauma successfully treated using a combination of muscle-sparing minithoracotomy with VATS techniques (video-assisted minithoracotomy). A 22-year-old man was transferred to our department after a falling accident. A diagnosis of right-sided pneumothorax was made on physical examination and urgent chest decompression was performed with a tube thoracostomy. Chest computed tomographic scan revealed pulmonary laceration with hematoma in the right lung. The pulmonary hematoma extending along segmental pulmonary artery in the helium of the middle lobe ruptured suddenly into the thoracic cavity, resulting in hemorrhagic shock on the fourth day after admission. Emergency right middle lobectomy was performed through video-assisted minithoracotomy. We used two cotton dissectors as a chopstick for achieving compression hemostasis during surgery. The patient recovered satisfactorily. Video-assisted minithoracotomy can be an alternative approach for the treatment of pulmonary lacerations with a massive hemothorax in hemodynamically unstable patients.
url http://dx.doi.org/10.1155/2014/454970
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