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Massive hemoptysis and hemothorax： a rare but fatal complication of intralobar sequestration

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Chinese Medical Journal 2012年第14期125卷 2638-2640页

作者： WANG Hong-wei LU Jiang-yang SUN Jun-zhong, XIAO Yan WEN Bo Department of Patlaology First Affiliated Hospital of General Hospital of People's Liberation Army Beijing 100048 China Department of OncologyFirst Affiliated Hospital of General Hospital of People's Liberation Army Beijing 100048 China Respiratory Center First Affiliated Hospital of General Hospitalof People's Liberation Army Beijing 100048 China Department ofRadiology First Affiliated Hospital of General Hospitalof People's Liberation Army Beijing 100048 China

Intralobar sequestration （ILS） is an uncommon abnormality that accounts for 75% of all pulmonary sequestrations. Over the years there have been several reports of various presenting signs of which hemoptysis was commonly described, however, massive hemoptysis and hemothorax is extremely rare in literature. We present a case of a 45-year-old man who died of fatal complication from an ILS. This case report shows an uncommon presentation of ILS with massive hemoptysis and hemothorax resulting in a dramatic course of disease and a fatal outcome, and for this reason in the absence of trauma or other causes for massive hemoptysis, hemothorax, or lung hematoma, this possibility should be kept in mind so as to avoid misdiagnosis, and resection of the sequestered tissue should be considered in all patients.

关键词： hemoptysis hemothorax bronchopulmonary sequestration, autopsy

Massive hemothorax due to intercostal arterial bleeding after percutaneous catheter removal in a multiple-trauma patient: A case report

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World Journal of Clinical Cases 2021年第32期9卷 9942-9947页

作者： Chanhee Park Jeongwoo Lee Department of Surgery Dongsan Medical CenterKeimyung University School of MedicineDaegu 42601South Korea Division of Trauma Surgery Department of SurgeryDongsan Medical CenterKeimyung University School of MedicineDaegu 42601South Korea

BACKGROUND Intercostal arterial bleeding is unusual complication of percutaneous chest ***,intercostal arterial bleeding is likely to result in critical complications such as abnormalities in vital signs,hypovolemic shock,and death due to massive ***,it is very important to establish the diagnosis of intercostal arterial bleeding and to initiate *** SUMMARY We report a case in which a 59-year-old woman who was hospitalized at intensive care unit with multiple trauma had a massive hemothorax after the removal of a percutaneous *** sustained a refractory right pleural effusion due to biloma caused by a traumatic injury to the liver,despite persistent intraperitoneal *** a result,atelectasis persisted in the dependent portion of the right ***,we performed right percutaneous catheter drainage(8.5-F pigtail catheter)for pleural effusion drainage at the 7th intercostal *** percutaneous catheter removal,portable chest radiography and vital signs of the patient assisted in establishing a diagnosis of intercostal arterial *** arterial bleeding was also confirmed using transarterial angiography;and embolization was *** patient’s condition progressively improved,and no further intervention was *** Massive hemothorax is a rare complication of percutaneous catheter *** should carefully examine and diagnose patients to improve *** interventional selective angiography may be a feasible and minimally invasive treatment for intercostal arterial bleeding control.

关键词： Bleeding Drainage Intercostal artery hemothorax Pleural effusion Case report

Unilateral massive hemothorax in Dengue hemorrhagic fever:A unique presentation

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Asian Pacific Journal of Tropical Medicine 2012年第9期5卷 753-754页

作者： Suman S Karanth Anurag Gupta Mukhyaprana Prabhu Department of Medicine KMC ManipalKarnatakaIndia Department of Neurosurgery KMC ManipalKarnatakaIndia

Dengue hemorrhagic fever is a more serious form of disease characterised by plasma leakage syndrome,thrombocytopenia and disseminated intravascular *** present a 51 year old male who presented with fever,petechiae and acute onset of *** chest rhoentogram showed a massive riglit sided pleural *** insertion of intercostal drain,there was a sudden gush of blood tinged fluid suggestive of *** was no history of trauma or bleeding *** investigations revealed a raised hematocrit and severe *** IgM was surprisingly *** aggressive supportive management the patient gradually improved and was *** bilateral pleural effusion is a known occurrence in dengue hemorrhagic fever,massive hemothorax is unheard *** report the first case in literature ol dengue hemorrhagic fever presenting as unilateral massive hemothorax.A suspicion of dengue must also be borne in mind in cases of non-traumatic hemothorax especially in endemic areas.

关键词： Dengue hemorrhagic fever hemothorax Plasma leakage syndrome

hemothorax Revealing Aortic Aneurism and Aortic Dissection

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Open Journal of Respiratory Diseases 2013年第3期3卷 113-115页

作者： Fatma Chermiti Ben Abdallah Houda Gharsalli Hamida Kwas Sofia Taktak Amel Chtourou Ali Ben Kheder Pneumology IV department Abderrahman Mami Hospital Ariana Tunisie

hemothorax caused by rupture of aortic aneurysm or aortic dissection is an uncommon manifestation and carries a high mortality rate. We report two cases of 75- and 80-year-old men, who were referred to our department for exploration of a left pleural opacity. Thoracentesis produced a hemorrhagic fluid. The computed tomography scan revealed an aortic dissection type B of Stanford in the first case and an aneurysm of the descending thoracic aorta in the second patient. Emergency operation was performed in the first case but the patient died of multiple organ failure 48 hours after surgery. Aortic dissection or aneurysm can result in a hemothorax especially in patient with favourable conditions such as elderly patient and systemic hypertension. Diagnosis relies on computed tomography (CT) scan and echocardiography.

关键词： Aortic Aneurysm Aortic Dissection hemothorax Computed Tomography Scan Echocardiography

hemothorax induced by cardiac perforation resulting from two active screw-in leads: A case report

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World Journal of Cardiovascular Diseases 2013年第2期3卷 220-221页

作者： Hideki Morita Tsutomu Saito Yoshio Misawa Department of Cardiovascular Surgery Saitama Red Cross Hospital Saitama Japan Division of Cardiovascular Surgery Jichi Medical University Shimotsuke Japan

We describe the case of a 77-year-old female who underwent dual-chamber permanent pacemaker implantation using two active screw-in leads for complete atrioventricular block. The two active screw-in leads perforated the atrial and ventricular walls causing cardiac tamponade and a left hemothorax associated with ventricular perforation. An emergency sternotomy was performed to facilitate drainage and hemostasis. Although hemothorax due to pacing lead perforation is very rare, such a possibility should always be considered.

关键词： Pacemaker Pacing Complications hemothorax Screw-In Lead

Management of computed tomography scan detected hemothorax in blunt chest trauma:What computed tomography scan measurements say?

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World Journal of Radiology 2018年第12期10卷 184-189页

作者： Mahdi Malekpour Kenneth Widom James Dove Joseph Blansfield Mohsen Shabahang Denise Torres Jeffrey L Wild Department of Surgery Section of Trauma and Acute Care SurgeryGeisinger Medical Center

AIM To investigate the hemothorax size for which tube thoracostomy is *** Over a 5-year period, we included all patients who were admitted with blunt chest trauma to our level 1 trauma center. Focus was placed on identifying the hemothorax size requiring tube *** A total number of 274 hemothoraces were studied. All patients with hemothoraces measuring above 3 cm received a chest tube. The 50% predicted probability of tube thoracostomy was 2 cm. Pneumothorax was associated with odds of receiving tube thoracostomy for hemothoraces below 2 cm(Odds Ratio:4.967, 95%CI: 2.225-11.097, P hemothorax size greater than 3% underwent tube thoracostomy. Prospective studies are warranted to elucidate the clinical outcome of patients with smaller hemothoraces.

关键词： Chest trauma Blunt hemothorax Chest tube Occult Computed tomography scan

Occult hemothorax after Transcatheter Aortic Valve Implantation (TAVI)

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Open Journal of Anesthesiology 2013年第5期3卷 272-274页

作者： Kenneth D. Eichenbaum Bryan Noorda Walter Bethune Dennis E. Feierman Department of Anesthesiology Maimonides Medical Center New York USA.

We present a case of occult hemothorax, a rare but dangerous complication resulting from cannulation of the internal jugular vein. To date we are not aware of any case reports of bleeding sequelae resulting from direct parenchymal lung injury. The insidious nature of this complication, in which the clinical presentation occurred several hours after central venous cannulation, provides an important reminder for clinicians to follow up central line placement with imaging studies. In this case, the latent period prior to the appearance of clinical manifestations of hemorrhage along with the patient’s subsequent acute decompensation raises questions as to the nature of the underlying injury and mechanisms of both detection and prevention. The patient underwent two right video-assisted thoracoscopic surgical explorations, the first revealed ongoing venous bleeding from within the parenchyma of the right upper lobe which was controlled by a wedge resection. She was ultimately discharged home and, as of the time of this writing, appears to have recovered completely, suffering no long-term sequelae as a result of this complication.

关键词： Central Line Complication hemothorax TAVI

Video-Assisted Thoracic Surgery as a Less-Invasive Management for Acute hemothorax in Blunt Trauma

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Surgical Science 2012年第3期3卷 136-140页

作者： Yoshihiko Kurimoto Atsushi Watanabe Tetsuya Koyanagi Toshiro Ito Tetsuya Higami Kunihiko Maekawa Katsutoshi Tanno Yasufumi Asai Department of Thoracic and Cardiovascular Surgery Sapporo Medical University Sapporo Japan Department of Traumatology and Critical Care Medicine Sapporo Medical University Sapporo Japan

Purpose: We report our experience of Video-assisted thoracic surgery (VATS) to treat acute blunt traumatic hemothorax using mini-thoracotomy. Methods: We designed a prospective study to determine if VATS with mini-thoracotomy benefits for patients with blunt traumatic hemothorax compared with conventional repair through full thoracotomy. Twenty-five patients underwent emergency operation for acute hemothorax from 2000. Five patients with less than 5% probability of survival (PS) were excluded, leaving 20 as the subjects. Results: Ten patients underwent conventional thoracotomy (conventional group) and the other 10 patients underwent VATS with mini-thoracotomy (VATS group). There was no difference between conventional group and VATS group in injury severity score (29.1 and 27.0) or PS (81.2% and 80.7%). Hospital mortality rates were 10% in conventional group and 0% in VATS group (N.S). Total amounts of intra-operative bleeding and post-operative transfusion until day 7 were 735 ml and 19.3 units in conventional group and 303 ml and 9.2 units in VATS group respectively (N.S). The length of ICU stay was 9.7 days in conventional group and 5.9 days in VATS group (N.S). Conclusion: VATS with mini-thoracotomy can be alternative for patients with blunt traumatic hemothorax in most emergency operations.

关键词： hemothorax Trauma Video-Assisted Thoracic Surgery Emergency Surgery Critical Care

Thoracoscopy in Cameroon: Indications, Technics and Short Term Results

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Surgical Science 2024年第4期15卷 278-288页

作者： Guy Aristide Bang Richard II Mbele Fabrice Stephane Arroye Betou Arlette Joelle Moukitek Banaken Amos Bella Ela Charles Mve Mvondo Arthur Essomba Department of Surgery and Specialities Faculty of Medicine and Biomedical Sciences Yaound&#233 I University Yaound&#233 Cameroon Department of Surgery and Specialities Yaound&#233 Teaching Hospital Yaound&#233 Cameroon General Surgery Service Mvog-Ada District Hospital Yaound&#233 Cameroon Department of Cardiothoracic and Vascular Surgery Laquintinie Hospital Douala Cameroon Department of Cardiothoracic and Vascular Surgery Yaound&#233 General Hospital Yaound&#233 Cameroon Cardiac Center Shisong St. Elizabeth Catholic General Hospital Shisong Kumbo Cameroon

Introduction: Thoracoscopy is a video-assisted surgical approach that mirrors the techniques used in thoracotomy. Our aim is to map the current state of thoracoscopy practice in Cameroon’s hospitals. Methods: This was a descriptive study that collected both retrospective and prospective data over 57 months across four hospitals in Cameroon. It included 13 patients and focused on variables such as socio-demographic factors, clinical profiles, surgical procedures, and postoperative follow-up. Results: Thirteen patients, predominantly male (84.6%, n = 11), with a mean age of 37.5 ± 16 years, were enrolled. Alcohol use (61.5%) and smoking (38.5%) were the most common past histories. The major complaints were dyspnea (84.6%) and chest pain (58.3%). The primary surgical procedure was clot-free thoracoscopy in 30.8% of cases, mainly for persistent hemothorax (41.8%). Most surgeries were elective (76.9%) and performed under general anesthesia with selective intubation (61.5%). The most common approach was single-port thoracoscopy (U-VATS) (76.9%), with no reported difficulties;however, one intraoperative incident occurred and was successfully treated. Drainage was performed systematically in all patients, and one case required conversion to open surgery. Postoperative complications were minor (Clavien-Dindo grade I) and mainly consisted of pain, with a mortality rate of 15.4%. No significant association was found between risk factors and the occurrence of complications or postoperative mortality. Conclusion: Thoracoscopy, a novel approach in our context, primarily focuses on minor thoracic surgeries.

关键词： Thoracoscopy Single-Port hemothorax Cameroon