Left superior pulmonary venous thrombosis complicated with splenic infarction after video-assisted thoracoscopic left upper lobectomy.

ABSTRACT

A 72-year-old man underwent video-assisted thoracoscopic left upper lobectomy for small cell lung cancer. After 16 days, he experienced epigastric abdominal pain and vomiting, and was taken by ambulance to our hospital. Contrast-enhanced computed tomography (CT) showed a propagation of thrombus in the stump of the left superior pulmonary vein (LSPV) complicated with splenic infarction. The patient received anticoagulation therapy with heparin and warfarin, and further progression of the thrombus or any systemic embolic event was not observed during hospitalization. Here, we report a patient presenting with LSPV thrombosis complicated with splenic infarction after video-assisted thoracoscopic surgery (VATS), and describe several months follow-up CT imaging results after administration of an oral anticoagulation therapy. <Learning objective: Pulmonary venous thrombosis after lung surgery is a rare, but critical, condition. Only few cases have been previously reported and all cases described LSPV thrombus. We also demonstrated LSPV thrombus after VATS lobectomy, and clearly showed follow-up results after anticoagulation therapy. Our case indicates the need for periodic CT imaging follow-up after left upper lobectomy and may call attention to thoracic surgeons, internal medicine, and cardiology physicians regarding this complication.>.