Elective surgery for liver injury and misinserted tube into the inferior vena cava associated with chest tube replacement: A case report

IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Acute Medicine & Surgery Pub Date : 2024-03-18 DOI:10.1002/ams2.943

Hiroshi Homma, Kenichiro Uchibori, Fumimasa Kobori, Kentaro Kawai, Kazunari Azuma, Shoji Suzuki, Kotaro Uchida, Jun Oda

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Abstract

Background

Several reports on organ injury and death due to incorrect chest tube insertion exist; however, reports on the chest tube penetrating the liver and reaching the inferior vena cava are limited.

Case Presentation

A 79-year-old man presented with a clamped tube because of massive bleeding from the tube following right chest tube replacement in the hospital of origin. The tube entered the inferior vena cava from the hepatic parenchyma via the right hepatic vein and was removed 15 h later because his hemodynamics stabilized. A ruptured pseudoaneurysm necessitated further transcatheter arterial embolism on the second hospitalization day, and the patient was transferred back to the referring hospital on day 17.

Conclusion

Liver injury caused by an inferior vena cava misinsertion-associated chest tube can be treated with elective surgery in anticipation of the tube's tamponade effect. However, due to the risk of rebleeding, imaging follow-up is necessary soon after surgery.

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因肝脏损伤而进行的择期手术，以及与胸管置换术相关的误将管道插入下腔静脉：病例报告

背景有多篇关于胸管插入错误导致器官损伤和死亡的报道，但关于胸管穿透肝脏并到达下腔静脉的报道却很有限。病例介绍一名 79 岁的男性在原住医院更换右胸管后，因胸管大量出血而被夹住。插管从肝实质经右肝静脉进入下腔静脉，15 小时后因血流动力学稳定而拔出。住院第二天，由于假性动脉瘤破裂，需要进一步经导管动脉栓塞，患者于第 17 天转回转诊医院。结论下腔静脉误插相关胸管导致的肝损伤可通过择期手术治疗，以期待胸管的填塞效果。然而，由于存在再出血的风险，术后不久就需要进行造影随访。

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Acute Medicine & Surgery MEDICINE, GENERAL & INTERNAL-

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12.50%

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53 weeks