Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2022 Apr 22:9:900396.
doi: 10.3389/fsurg.2022.900396. eCollection 2022.

Case Report: Hemodynamic Instability Caused by Splenic Rupture During Video-Assisted Thoracoscopic Lobectomy

Chun-Tong Liu  1   2 , Ting-Ting Wu  1   2 , Yun-Ying Ding  1   2 , Jin-Long Lin  1   2 , Shuang Zhou  1   2 , Hong Liu  3 , Fu-Hai Ji  1   2 , Ke Peng  1   2
Affiliations
Case Reports

Case Report: Hemodynamic Instability Caused by Splenic Rupture During Video-Assisted Thoracoscopic Lobectomy

Chun-Tong Liu et al. Front Surg. .

Abstract

Background: Video-assisted thoracoscopic surgery (VATS) has been widely performed for patients with lung cancer. Splenic rupture after VATS lung procedures is a very rare and serious event.

Case presentation: We reported a case with hemodynamic instability after left lower VATS lobectomy. There was no evidence of diaphragmatic injury during the surgery. Computed tomography (CT) showed spleen injury and large amount of fluid in the abdominal cavity. Emergent laparotomy was performed, and splenic rupture was diagnosed. The patient underwent splenectomy, with two lacerations at the diaphragmatic surface of the spleen. The patient did well postoperatively and was discharged from the hospital on postoperative day 5.

Conclusion: There are few similar cases reported in the literature. Persistent hemodynamic instability due to the rupture of spleen is life-threatening. In the situation of unexplained hypotension during VATS procedures (especially left-sided approaches), the possibility of splenic injury and rupture should be considered. Abdominal ultrasonography and/or CT examinations should be carried out for prompt diagnosis and treatment of such rare complication.

Keywords: anesthesia management; hemodynamic instability; splenic rupture; urgent splenectomy; video-assisted thoracoscopic surgical.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Images of abdominal computed tomography and ruptured spleen. (A) Abdominal computed tomography showing splenic hematoma and large amount of free intraperitoneal fluid. (B) Two lacerations of the ruptured spleen.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Boffa DJ, Dhamija A, Kosinski AS, Kim AW, Detterbeck FC, Mitchell JD, et al. Fewer complications result from a video-assisted approach to anatomic resection of clinical stage I lung cancer. J Thorac Cardiovasc Surg. (2014) 148(2):637–43. 10.1016/j.jtcvs.2013.12.045 - DOI - PubMed
    1. Flores RM, Ihekweazu U, Dycoco J, Rizk NP, Rusch VW, Bains MS, et al. Video-assisted thoracoscopic surgery (VATS) lobectomy: catastrophic intraoperative complications. J Thorac Cardiovasc Surg. (2011) 142(6):1412–7. 10.1016/j.jtcvs.2011.09.028 - DOI - PubMed
    1. Forti Parri SN, Guiducci GM, Domanico A, Tugnoli G. Splenic rupture after videothoracoscopic procedure: an unusual complication conservatively managed. J Thorac Cardiovasc Surg. (2014) 148(5):e236–7. 10.1016/j.jtcvs.2014.08.004 - DOI - PubMed
    1. Zhang Z. A care report of splenic rupture with subcapsular hematoma after thoracoscopic surgery. Chin J Endosc. (2001) 5(7):27. [Article in Chinese]. 10.3969/j.issn.1007-1989.2001.05.064 - DOI
    1. Li J, Wang L. Anesthesia management for a patient with splenic rupture during thoracoscopic surgery. J Clin Anesthesiol. (2018) 34(3):312. [Article in Chinese]. 10.12089/jca.2018.03.026 - DOI

Publication types