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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Delayed Hemothorax Following Trauma in a COVID-19 Positive Patient Requiring Video-Assisted Thoracoscopic Surgery: A
William S Kim1, Mari Iwasaki1, Peiman Arghavanifard1
1Internal Medicine, California Hospital Medical Center, Los Angeles, USA.
Abstract:
Delayed hemothorax (DHTX) is a possible sequelae of thoracic trauma, especially in the setting of patients being treated with anticoagulation. We report the case of an 81-year-old Caucasian man with a DHTX presenting 14 days following an initial emergency department (ED) visit with multiple rib fractures due to a fall from the patient's bed. Upon presentation to the ED a second time, the patient was hospitalized, tested positive for COVID-19, and on the second day of admission underwent video-assisted thoracoscopic surgery (VATS) without bleeding or other complications. This case illustrates that the initial weeks following thoracic trauma present a critical time window during which monitoring for complications such as spontaneous or DHTX can be beneficial, especially in patients being treated with anticoagulant medication. VATS is safe in patients who can tolerate single-lung anesthesia and provides a less invasive way to resolve the underlying pathology while providing comparable or even improved clinical outcomes, and should be considered when treating patients with hemothorax.
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