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Emergency surgery for hemothorax due to a ruptured pulmonary arteriovenous malformation

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Abstract

Pulmonary arteriovenous malformation (PAVM) is a potential cause of hemothorax. The risk of PAVM rupture is reported to be higher during pregnancy for several reasons, including increased body fluid and a change in hormonal conditions. A 34-year-old pregnant woman suddenly felt right chest pain and dyspnea in the 28th week of gestation. Chest X-ray and computed tomography showed massive right pleural effusion. Her vital signs gradually deteriorated with hemorrhagic shock, necessitating emergency surgery. During exploratory thoracoscopy, active bleeding from the middle lobe was noticed and gauze packing was required to maintain her blood pressure. Following conversion to major thoracotomy, wedge resection of the middle lobe was performed with a linear stapler, and finally, her general condition became stable. Her postoperative course was uneventful. A histological examination of the resected specimen confirmed the diagnosis of ruptured PAVM. Her baby was successfully delivered at the 38th week of gestation.

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Authors and Affiliations

  1. Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Jun Naito, Takahiro Nakajima, Junichi Morimoto, Takayoshi Yamamoto, Yuichi Sakairi, Hironobu Wada, Hidemi Suzuki & Ichiro Yoshino

  2. Department of Respiratory Medicine, Chiba University Graduate School of Medicine, Chiba, Japan

    Toshihiko Sugiura & Koichiro Tatsumi

Authors
  1. Jun Naito
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  2. Takahiro Nakajima
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  3. Junichi Morimoto
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  4. Takayoshi Yamamoto
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  5. Yuichi Sakairi
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  6. Hironobu Wada
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  7. Hidemi Suzuki
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  8. Toshihiko Sugiura
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  9. Koichiro Tatsumi
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  10. Ichiro Yoshino
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Correspondence to Takahiro Nakajima.

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Naito, J., Nakajima, T., Morimoto, J. et al. Emergency surgery for hemothorax due to a ruptured pulmonary arteriovenous malformation. Gen Thorac Cardiovasc Surg 68, 1528–1531 (2020). https://doi.org/10.1007/s11748-020-01291-9

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  • DOI: https://doi.org/10.1007/s11748-020-01291-9

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