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Wire 'missing': a rare presentation of preoperative localization wire system dislocation.
Xiaofeng Chen, Shaohua Wang1, Zhenhua Hao
1Department of Thoracic Surgery, Huashan Hospital, Fudan University, No 12, Middle Urumqi Rd, Shanghai 200040, China. wangsh@fudan.edu.cn.
Journal of Cardiothoracic Surgery
|October 1, 2014
Summary
A misplaced localization wire during lung surgery was successfully retrieved from the chest wall using bedside imaging. This allowed for the safe removal of a small pulmonary nodule diagnosed as atypical alveolar hyperplasia.
Area of Science:
- Thoracic Surgery
- Medical Imaging
- Pulmonary Medicine
Background:
- Preoperative localization of small pulmonary nodules is crucial for minimally invasive thoracic surgery.
- Computed tomography (CT)-guided wire localization is a common technique for guiding surgical resection.
Observation:
- A Dualok-wire system successfully localized a subpleural nodule preoperatively.
- During surgery, the localization wire became dislodged and was not found within the thorax or lung.
- A bedside chest film identified the 'missing' wire twisted within the patient's chest wall.
Findings:
- The dislodged wire was successfully retrieved via a separate small incision.
- Posterior segmentectomy was performed for the pulmonary lesion.
- Pathological diagnosis confirmed the lesion as atypical alveolar hyperplasia.
Implications:
- This case highlights the potential for unexpected complications during CT-guided wire localization.
- Prompt bedside imaging is essential for managing dislodged localization devices.
- Successful retrieval and subsequent resection demonstrate the feasibility of managing such intraoperative challenges.
