Component blood transfusion used to treat massive postoperative hemorrhage after resection of a thoracic tumor: a case report

Abstract

Introduction and importance: Perioperative bleeding is a common complication of thoracic surgery. Massive bleeding after thoracic surgery usually requires secondary thoracotomy to achieve hemostasis. We report a patient who developed massive hemorrhage after resection of a large thoracic tumor. Such a massive hemorrhage has not been performed with secondary thoracotomy, which has not been reported yet. Case presentation: A 76-year-old man was suffering from chest pain for 3 weeks. Chest computed tomography showed a large thoracic tumor with a maximum diameter of ~160 mm. Tumor puncture cytology showed no cancer cells, but histopathologic examination revealed large amount of necrotic tissue. After detailed preoperative evaluation, the patient underwent tumor resection and pleural peeling. The patient developed massive thoracic hemorrhage after the surgery. This postoperative intrathoracic hemorrhage was controlled by infusion of large amounts of cryoprecipitate and other blood products. Conclusions: Our experience with this patient suggests that massive hemorrhage in such cases can be managed by blood transfusion instead of secondary thoracotomy. The key point is determining whether the hemorrhage is due to oozing from surgical wound or an active vascular bleed.