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Clinical Communications: Adult| Volume 64, ISSUE 5, P635-637, May 2023

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Delayed Arterial Bleed After Pulmonary Lobectomy

Published:February 28, 2023DOI:https://doi.org/10.1016/j.jemermed.2023.02.002

      Abstract

      Background

      Postlobectomy hemorrhage is rare. The majority of the bleeding happens early after surgery, with the median time to reoperation being 17 hours.

      Case Report

      A 64-year-old man with a lung nodule underwent video-assisted thoracic surgery right upper lobectomy 3 weeks prior and presented to the Emergency Department (ED) with acute-onset chest pain and shortness of breath in the setting of delayed hemothorax from acute intercostal artery bleeding.

      Why Should an Emergency Physician Be Aware of This?

      The vast majority of the patients presenting to the ED with a hemothorax have a known history of trauma. It is important for emergency physicians to consider and recognize hemothorax in nontraumatic patients, especially those who underwent recent lung surgeries. Delayed postoperative hemorrhage is rare but possible, and can be life threatening.

      Keywords

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      References

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        • Soni M
        • Madariaga ML
        • et al.
        Incidence, aetiology and outcomes of major postoperative haemorrhage after pulmonary lobectomy.
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        Delayed postoperative bleeding following lobectomy caused by the sharp tip of a suture: a case report.
        Surg Case Rep. 2020; 6: 261