[Bleeding by staple in video-assisted thoracoscopic interlobar plasty of the lung]

A 58-year-old man underwent video-assisted thoracoscopic right upper lobectomy. He was discharged without event on postoperative day 8. On postoperative day 12, he visited emergently in a pre-shock state. Chest radiography showed massive right pleural effusion and intrathoracic bleeding was suspected. Thoracotomy was immediately performed and the bleeding point was identified as an internal thoracic artery. Hemostasis was performed but no cause of arterial injury was apparent. In another case, we had seen incidental snag the pleura on the internal thoracic artery by a staple from interlobar plasty of the lung. We therefore suspected that the cause in this case was injury of the internal thoracic artery by staple during video-assisted thoracoscopic interlobar plasty of the lung.