title: Pulmonary artery injury during mediastinoscopy controlled without gauze packing.
abstract: The most serious complication that can occur during mediastinoscopy is hemorrhage from large vessels in the mediastinum, whereas there are few articles relating to injury to major vessels. We describe a case of 77-year-old male with mediastinal lymphadenopathy, who underwent a mediastinoscopy procedure. When the pretracheal lymph nodes adjoining the right pulmonary artery were biopsied, a massive amount of bleeding spilled out through the scope. Immediately, the scope was removed from the body and the bleeding was controlled with digital compression at the skin incision. Then we closed the incision in a three-layer manner without any gauze packing in the mediastinum. Although some reports recommended gauze packing for massive bleeding during mediastinoscopy, we believe not all cases need gauze packing because bleeding from a low-pressure circulation system component into closed compartment, such as mediastinum, would cease without resulting in a large hematoma or pseudoaneurysm.
authors.affiliation: Ohta-Nishinouchi Hospital, Department of General Thoracic Surgery, Koriyama, Japan.
authors.forename: Muneo
authors.initials: M
authors.lastname: Minowa
authors.forename: Masayuki
authors.initials: M
authors.lastname: Chida
authors.forename: Syunsuke
authors.initials: S
authors.lastname: Eba
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsumura
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006491:Hemothorax / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008481:Mediastinoscopy / Q000009:adverse effects*; D011651:Pulmonary Artery / Q000293:injuries*; D014057:Tomography, X-Ray Computed