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Journal Information
Vol. 20. Issue 4.
Pages 169-172 (July - August 1984)
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Vol. 20. Issue 4.
Pages 169-172 (July - August 1984)
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Hemorragia masiva procedente de pleurotomia abierta en un empiema calcificado: tratamiento con ligadura intrapericardica de arteria y venas pulmonares
Massive bleeding from an open pleurotomy in a calcified empyema: treatment by intrapericardial ligation of pulmonary artery and veins
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4443
F.A. De Linera, J.L. Cofiño, J.L. Naya, J. Rodriguez, F. Gosalbez
Servicio de Cirugía Torácica. Hospital General de Asturias. Oviedo
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Un paciente de 54 años, a quien se le practicó una pleurotomía abierta, para tratamiento de un empiema crónico, con calcificaciones pleurales importantes, sufrió una hemorragia severa en la cavidad pleural residual, ingresando en estado de shock hipovolémico.

Controlada, inicialmente, la sangría con taponamiento, se procedió a la ligadura intrapericárdica de arteria y venas pulmonares, a través de esternotomía media, lo que detuvo la hemorragia de modo inmediato, por completo y definitivamente. Veinte días más tarde, se le practicó toracoplastia sin conseguir colapsar inicialmente la cavidad pleural residual, que lentamente se obliteró posteriormente de forma espontánea. El paciente se encuentra libre de síntomas cinco años más tarde.

A 54 year-old patient who had an open pleurotomy to treat a chronic empyema with significant pleural calcifications had a severe hemorrhage into the residual pleural cavity which prompted hospitalization of the patient in hypovolemic shock.

After initially controlling the hemorrhage by occlusion, intrapericardial ligation of the pulmonary artery and veins was performed through a medial sternostomy which stopped the bleeding completely. A thoracoplasty was done 20 days later but the residual pleural cavity could not be closed; this slowly took place spontaneously at a later stage. 5 year later the patient is free of symptoms.

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Copyright © 1984. Sociedad Española de Neumología y Cirugía Torácica
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