Multiple traumas with coagulation abnormality treated by video-assisted thoracoscopy

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  • 凝固異常を呈した多発外傷例を胸腔鏡下で止血した一例

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<p>Chest trauma is common in cases of multiple traumas and can be fatal. We encountered a case in which persistent bleeding associated with multiple traumas with a coagulation abnormality was successfully controlled with minimum wound formation through video-assisted thoracoscopy (VATS). An 89-year-old man experienced an injury to his chest and abdomen due to a traffic accident. Computed tomography revealed diaphragm rupture, splenic injury, and mesenteric damage. Therefore, emergency laparotomy, transabdominal diaphragm repair, and intrathoracic observation were performed. After closure, we performed VATS because of persistent hemorrhage from the chest tube. Observing the bleeding point and arresting bleeding with marked accuracy made it possible to arrest the bleeding while minimizing the size of the open wound. Although the main choice for chest trauma management is thoracotomy, by reducing the size of the wound in the presence of abnormal coagulation, the risk of sustained bleeding can be reduced and surgical invasion can be suppressed. Thoracoscopic surgery may be useful for patients with chest trauma who exhibit persistent bleeding in cases of abnormal coagulation despite stable circulation.</p>

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