title: Extrapleural hematoma as a complication following thoracotomy for pulmonary lobectomy.
abstract: Extrapleural hematoma as a complication following thoracic surgery is rare. We report a case of an extrapleural hematoma following pleural lobectomy that resolved completely with nonsurgical treatment. A 63-year-old woman underwent left lower lobectomy for lung cancer through a left posterolateral thoracotomy. She had been prescribed the anticoagulant cilostazol to increase her heart rate for atrioventricular dissociation. Preoperatively, it was stopped, and a temporary pacemaker was placed to counteract bradycardia via the right jugular vein without complication. The chest tube was removed, and cilostazol was resumed on the third postoperative day. On day 7, she suddenly experienced left shoulder pain followed by hypotension, tachycardia, and anemia. Enhanced computed tomography (CT) revealed an extrapleural hematoma rather than a hemothorax. She became symptomatic after rapid infusion. The hematoma resolved without an invasive intervention. The CT results 189 days after the onset showed almost complete regression of the hematoma.
authors.affiliation: Division of Surgical Oncology, Graduate School of Medicine, Hokkaido University, North 15, West 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
authors.forename: Takuro
authors.initials: T
authors.lastname: Noguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hida
authors.forename: Kichizo
authors.initials: K
authors.lastname: Kaga
authors.forename: Masaya
authors.initials: M
authors.lastname: Kawada
authors.forename: Hiroto
authors.initials: H
authors.lastname: Niizeki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo
mesh_terms: D005260:Female; D006406:Hematoma / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects* / Q000379:methods; D012075:Remission, Spontaneous; D013908:Thoracotomy / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed