Video-Assisted Minithoracotomy for Pulmonary Laceration with a Massive Hemothorax. (13th March 2014)

• Record Type: Journal Article
• Authors: Ota, Hideki; Kawai, Hideki; Togashi, Shuntaro; Matsuo, Tsubasa
• Other Names: Bojić L. Academic Editor.; Lin J. D. Academic Editor.; Mauritz W. Academic Editor.
• Is Part Of: Case reports in emergency medicine. Volume 2014(2014)
• Publication Date: 2014-03-13
• Subjects: Emergency medicine -- Periodicals; Emergency Medicine; Emergency medicine; Periodicals; Periodicals; Case Reports; Fulltext; Internet Resources; Periodicals; 616.025
• DOI: 10.1155/2014/454970
• Languages: English
• ISSNs: 2090-648X

Abstract

Abstract : 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.