METHODS: A 71-year-old man was suspected of having lung cancer and underwent a right upper lobectomy. During the dissection of the peribronchial connective tissue around the upper lobe bronchus, a sudden massive hemorrhage occurred after separation of the pulmonary artery and vein. Hemostasis was difficult to achieve with compression hemostasis and the point of bleeding was unknown; thus, we were called in to search for the source of the bleeding, which was identified as the bronchial artery. Postoperatively, a racemose hemangioma was diagnosed via preoperative chest computed tomography and imaging analysis with the Ziostation2® (Ziosoft Inc. Tokyo, Japan).
UNASSIGNED: Racemose hemangioma has weaker blood vessel walls than normal blood vessels. Once bleeding occurs, it is very difficult to stop. However, once the bleeding point was identified, hemostasis via suturing and cutting was possible.
CONCLUSIONS: As hemorrhaging from a racemose hemangioma is very difficult to stop, preoperative imaging retrieval is very important.
方法:一名71岁男子被怀疑患有肺癌,并接受了右上叶切除术。在上叶支气管周围的支气管周围结缔组织的解剖过程中,肺动脉和静脉分离后突然大出血。压迫止血很难实现止血,出血点未知;因此,我们被叫去寻找出血的源头,被确定为支气管动脉。术后,通过术前胸部计算机断层扫描和Ziosstation2®的影像学分析诊断为总状血管瘤(ZiosoftInc.Tokyo,日本)。
未经证实:消旋血管瘤的血管壁比正常血管更弱。一旦出血,很难停下来。然而,一旦确定了出血点,通过缝合和切割止血是可能的。
结论:因为总状血管瘤的出血很难阻止,术前影像检索非常重要。