Bedside resuscitative thoracotomy in response to cardiopulmonary arrest due to fatal hemothorax: a case report

Anterior thoracotomy is an established approach in thoracic surgery, but life-threatening emergencies often occur under limited resources. We report a man in his 70s who developed cardiopulmonary arrest from massive postoperative hemothorax after right lower lobectomy. Resuscitative thoracotomy was required at the bedside before transfer to the operating room. With only a scalpel and scissors available, an anterolateral thoracotomy through the fifth intercostal space was extended cephalad by transecting costal cartilages, creating a hemiclamshell exposure within 1 minute. Manual hilar compression and gauze packing allowed temporary control, followed by definitive hemostasis in the operating room. The patient recovered without neurological sequelae or other complications following the resuscitative operation. This case highlights that bedside resuscitative thoracotomy can be performed successfully using only basic instruments.