Life‐threatening extrapleural hematoma in an anticoagulated patient 2 weeks after lobectomy

• Published in: Thoracic cancer Vol. 12; no. 21; pp. 2953 - 2955
• Main Authors: Shimomura, Masanori, Iwasaki, Masashi, Shimegi, Reona, Inoue, Masayoshi
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.11.2021; John Wiley & Sons, Inc; Wiley
• Subjects: Aged, 80 and over; anticoagulant; Anticoagulants; Anticoagulants - therapeutic use; Case Report; Case Reports; Chest tubes; chest wall; Defecation; extrapleural hematoma; Factor Xa Inhibitors - therapeutic use; Hematoma; Hematoma - etiology; Hematoma - surgery; Hemoptysis; Heparin - therapeutic use; Humans; lung cancer; Lung Neoplasms - surgery; Male; Neoplasms, Squamous Cell - surgery; Ostomy; Patients; pleura; Pleural Diseases - etiology; Pleural Diseases - surgery; Pneumonectomy - methods; Postoperative Complications - surgery; Pyrazoles - therapeutic use; Pyridones - therapeutic use; Trauma; Vital signs; lung cancer; chest wall; anticoagulant; pleura; extrapleural hematoma
• ISSN: 1759-7706; 1759-7714
• DOI: 10.1111/1759-7714.14160

We report a case of an anticoagulated patient with sudden onset pleural hematoma after straining at defecation to cardiac arrest on 2 weeks after lobectomy for lung cancer. We decided to perform an emergent operation for an evacuation of extrapleural hematoma immediately after resuscitation. The bleeding point was revealed on the extrapleural thoracic apex. We should be aware that extrapleural hematoma can occur because of increased intrathoracic pressure such as straining during defecation in patients on anticoagulation. Extrapleural hematoma can occur because of increased intrathoracic pressure, such as that caused by straining during defecation in anticoagulated patients.