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Splenic rupture after video-assisted thoracoscopic lobectomy: a case report
Xibei Hu1, Huixiang Xu1,2, Yanhu Xie1
1Department of Anesthesiology, Division of Life Science and Medicine, The First Affiliated Hospital of USTC (Anhui Provincial Hospital), University of Science and Technology of China, Hefei, Anhui 230036, China.
None:
This report details a rare splenic rupture following left video-assisted thoracoscopic lobectomy in a 50-year-old male. Intraoperative tachycardia (78 → 110 bpm) and postoperative refractory hypotension (56/33 mmHg) progressed to hemorrhagic shock (Hb 57 g/L) at 90 min post-op. E-FAST confirmed splenic rupture with hemoperitoneum, leading to emergent splenectomy for a 3-cm diaphragmatic surface laceration (3000 mL blood loss). Unique features include: (i) Traction-mediated injury despite intact diaphragm; (ii) Diagnostic delay from nonspecific early signs. This case underscores the need for vigilance regarding remote organ injury in minimally invasive thoracic surgery, advocating systematic protocols to manage this lethal complication.
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