A case of unusually persistent traumatic intrapulmonary hematoma

Kawagishi, Sachi; Kogita, Yuya; Nakamichi, Itsuko; Matsui, Takahiro; Tokunaga, Tohru

doi:10.1016/j.rmcr.2021.101507

Cited by 3 publications

(5 citation statements)

References 9 publications

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“…For the surgical treatment of pulmonary visceral subpleural hematoma, procedures such as CT-guided drainage and surgical evacuation of hematoma are selected [2,3,4]. In the present case, less invasive CTguided drainage of hematoma was attempted rst.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Pulmonary hematoma is reported to usually remain asymptomatic and, without an increase in bleeding or infection, disappear in several to 6 months [4]. If it is expected to be complicated by bleeding or infection, surgery is necessary [2,3], and there have also been undiagnosed cases for which diagnostic treatments were selected [4]. In the present case, intervention by procedures such as drainage was considered necessary from enlargement of hematoma during antiplatelet and anticoagulant therapies in a relatively short period after the responsible trauma and persistence of hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

“…Procedures including wedge resection, segmentectomy, evacuation of hematoma by pleural incision, and running suture of the defect after evacuation of hematoma have been reported as surgical treatments for visceral subpleural hematoma [2,3,4]. Since the hematoma in our case extended over a wide area in the right lower lobe, we treated it by open chest evacuation of hematoma and reinforcement with TachoSil Tissue Sealing sheet® (CSL Behring) and Polyglycolic acid sheet alone in expectation of recovery of pulmonary function after evacuation of hematoma.…”

Section: Discussionmentioning

confidence: 99%

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A case of pulmonary visceral subpleural hematoma that arose after cardiopulmonary resuscitation treated by hematoma evacuation

Funaki

Hirai²

2023

Preprint

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Background The occurrence of pulmonary visceral subpleural hematoma as a complication of sternal compressions during cardiopulmonary resuscitation is extremely rare. Also, reports about the treatment of visceral subpleural hematoma are few, and there is room for discussion. Case presentation A 58-year-old male with histories of rheumatoid arthritis, chronic atrial fibrillation, hypertension, diabetes, and dyslipidemia developed ventricular fibrillation due to myocardial infarction and fainted. He received bystander cardiopulmonary resuscitation and direct cardioversion by the ambulance crew and had return of spontaneous circulation. After transfer to our hospital, the patient underwent percutaneous catheter intervention and stenting with a diagnosis of myocardial infarction, followed by anticoagulant and antiplatelet therapies. On the 8th hospital day, chest radiography suggested right lower lobe pneumonia, and subsequent chest computed tomography revealed pulmonary hematoma in the visceral subpleural area from S6 to S10. Since no improvement was observed in hypoxemia, treatment was considered necessary. First, an attempt at computed tomography-guided drainage of hematoma was made, but because insertion of the Pig-tail catheter was difficult due to hardness of the hematoma, evacuation of hematoma was performed on the 13th hospital day. The hematoma was located in the visceral subpleural area and was removed by incising the pleura. TachoSil Tissue Sealing sheet® and Polyglycoal acid sheet were applied to the sites of air leakage and oozing after hematoma evacuation. No re-bleeding or air leakage was observed after the treatment, and the patient was discharged on the 26th hospital day after an uneventful course. Conclusions Pulmonary visceral subpleural hematoma may occur as a complication of chest compression. In our case, CT-guided puncture and drainage was unsuccessful, and surgical treatment by incision of the visceral pleura and hematoma evacuation alone was effective.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of pulmonary visceral subpleural hematoma that arose after cardiopulmonary resuscitation treated by hematoma evacuation

Funaki

Hirai²

2023

Preprint

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“…Although difficult to recognize in rare cases, pulmonary hematomas are diagnosed easily because they resolve within a few weeks ( 2 ). Pulmonary hematomas usually demonstrate reduced FDG uptake ( 3 ). The high FDG accumulation observed in this case may be attributed to inflammatory cell infiltration resulting from acute pulmonary trauma ( 4 , 5 ).…”

mentioning

confidence: 99%

Post-Traumatic Pulmonary Hematoma Presenting as Multiple Ring-shaped Spherical Nodules

Ikeda,

Shimizu,

Yamada

et al. 2023

Am J Respir Crit Care Med

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A case of pulmonary visceral subpleural hematoma treated by hematoma evacuation during care of post-cardiopulmonary resuscitation

Funaki,

Hirai

2024

J Cardiothorac Surg

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Background The occurrence of pulmonary visceral subpleural hematoma during care of post-cardiopulmonary resuscitation including chest compressions and anticoagulant and antiplatelet therapies is extremely rare. Also, there are few reports of treatment of visceral subpleural hematoma, most of which are treated by lung resection. Here we describe a rare case that pulmonary visceral subpleural hematoma arose during post-cardiopulmonary resuscitation care and was treated by hematoma evacuation. Case presentation A 58-year-old male with no smoking history and, past medical histories of rheumatoid arthritis, chronic atrial fibrillation, hypertension, diabetes, and dyslipidemia developed ventricular fibrillation due to myocardial infarction and fainted. He received bystander cardiopulmonary resuscitation and defibrillation by the ambulance crew and had return of spontaneous circulation. After transfer to our hospital, the patient underwent percutaneous catheter intervention and stenting with a diagnosis of myocardial infarction, followed by anticoagulant and antiplatelet therapies. On the 8th hospital day, chest radiography suggested right lower lobe pneumonia, and subsequent chest computed tomography revealed pulmonary hematoma in the visceral subpleural area from S6 to S10. Since no improvement was observed in hypoxemia, treatment was considered necessary. First, an attempt at computed tomography-guided drainage of hematoma was made, but insertion of the Pig-tail catheter was difficult due to hardness of the hematoma. Next, evacuation of hematoma was performed on the 13th hospital day. The hematoma was located in the visceral subpleural area and was removed by incising the pleura. TachoSil Tissue Sealing sheet and Polyglycoal acid sheet were applied to the sites of air leakage and oozing after hematoma evacuation. No re-bleeding or air leakage was observed after the treatment, and the patient was discharged on the 26th hospital day after an uneventful course. Conclusions Pulmonary visceral subpleural hematoma may occur during post-cardiopulmonary resuscitation care, including chest compressions and anticoagulant and antiplatelet therapies. In our case, CT-guided puncture and drainage was difficult and surgical treatment by incision of the visceral pleura and hematoma evacuation alone was done successfully.

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A case of unusually persistent traumatic intrapulmonary hematoma

Cited by 3 publications

References 9 publications

A case of pulmonary visceral subpleural hematoma that arose after cardiopulmonary resuscitation treated by hematoma evacuation

A case of pulmonary visceral subpleural hematoma that arose after cardiopulmonary resuscitation treated by hematoma evacuation

Post-Traumatic Pulmonary Hematoma Presenting as Multiple Ring-shaped Spherical Nodules

A case of pulmonary visceral subpleural hematoma treated by hematoma evacuation during care of post-cardiopulmonary resuscitation

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