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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Series: | Case Reports in Emergency Medicine |
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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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