Postoperative Delayed Splenic Rupture After Video-Assisted Thoracoscopic Lobectomy
Overview
This report describes a case of delayed splenic rupture (DSR) following video-assisted thoracoscopic surgery (VATS) for lung cancer. The patient, a 70-year-old male, experienced DSR on postoperative day 6, highlighting the need for vigilance in monitoring patients after thoracic procedures.
Background
Video-assisted thoracoscopic surgery (VATS) is commonly used for early-stage lung cancer due to its benefits, including reduced trauma and quicker recovery. However, complications such as delayed splenic rupture (DSR) can occur, which may lead to severe outcomes like hemorrhagic shock. Understanding the risk factors and clinical presentation of DSR is essential for timely diagnosis and management.
Data Highlights
No numerical or trial data presented in the article.
Key Findings
Delayed splenic rupture (DSR) can occur after VATS, particularly following left-sided procedures.
DSR may present with hemodynamic instability and subtle abdominal findings, complicating diagnosis.
Intraoperative transdiaphragmatic injury and postoperative traction from adhesions are major risk factors for DSR.
Bedside ultrasonography (US) and diagnostic peritoneal paracentesis (DPP) are effective for emergency diagnosis of DSR.
Meticulous surgical technique and postoperative monitoring are critical to prevent DSR.
Clinical Implications
Clinicians should maintain a high index of suspicion for DSR in patients who have undergone left-sided thoracic surgery, especially if they present with unexplained hypotension or tachycardia postoperatively. Early recognition and intervention are crucial for improving patient outcomes.
Conclusion
This case underscores the importance of vigilance in postoperative monitoring for patients undergoing VATS, particularly regarding the risk of delayed splenic rupture.
