我们报告了一例电视胸腔镜手术(VATS)后延迟出血的病例,该病例通过经导管动脉栓塞术成功治疗。一名81岁的妇女通过VATS进行了胸膜活检,以治疗肺癌的胸膜播散。术后病程良好,但8天后,她因右腋窝肿胀住院,并被诊断为术后延迟出血。进行纱布压缩,患者出院后未出现血肿加重。然而,4天后,她因肿胀和疼痛迅速恶化而住院。再出血时的胸部计算机断层扫描显示,周围右胸外侧动脉的血肿和外渗增加。病人立即接受紧急血管造影治疗,并进行线圈栓塞。经过这种治疗,患者表现良好,没有出血复发。
We report a
case of delayed bleeding after video-assisted thoracic surgery (VATS) that was successfully treated with transcatheter arterial embolization. An 81-year-old woman underwent a pleural biopsy via VATS for pleural dissemination of lung cancer. The postoperative course was good, but 8 days later she was hospitalized for swelling in the right axilla and was admitted to our hospital with a diagnosis of delayed postoperative hemorrhage. Gauze compression was performed, and the patient was discharged without exacerbation of hematoma. However, 4 days later, she was hospitalized for rapidly worsening swelling and pain. Chest computed tomography at the time of rebleeding showed an increase in the hematoma and extravasation in the peripheral right lateral thoracic artery. The patient was immediately treated with emergency angiography, and coil embolization was performed. After this treatment, the patient has done well and there has been no subsequent recurrence of bleeding.