A man who went in for a routine surgery performed on more than 300,000 Americans a year almost died after suffering a rare complication that resulted in life-threatening internal bleeding.
The unnamed 65-year-old had been suffering from gangrenous appendicitis, a condition similar to acute appendicitis but with more severe symptoms, including severe abdominal pain, fever, nausea, and vomiting.
He underwent a routine operation to remove the organ, which is thought to play a role in the immune system.
Shortly after the surgery, the patient experienced chest pain and started coughing up blood.
The man’s levels of hemoglobin (a protein in red blood cells that carries oxygen throughout the body) dropped below the normal low limit to 13.2 g/dL.
Further tests looking at the man’s blood vessels and airways within his lungs revealed an area blocked with medical glue, which is sometimes used to close surgical wounds.
However, in extremely rare cases, glue can enter the bloodstream and travel to the lungs with this complication known as ‘glue embolism’.
In the case report, doctors wrote the glue formed a blockage that caused blood to fill the man’s chest cavity, in what doctors believe is the first-of-its-kind case.
A man who went in for a routine surgery performed on more than 300,000 Americans a year almost died after suffering a rare complication which caused internal bleeding
Glue embolism has a reported incidence of 0.5 percent to 4.3 percent, with its risk depending on the amount of glue used and the speed at which a substance is introduced into a system.
If medical glue gets into the bloodstream, it can cause the pulmonary arteries carrying blood from the heart to the lungs to become blocked.
In the male patient’s case, the blockage was causing the space between his lungs and chest wall – the pleural cavity – to fill with blood.
Bleeding into the pleural cavity (hemothorax) can be fatal, especially if the bleeding is severe or if the condition is not promptly treated. In some cases it can lead to the lungs collapsing.
Scar tissue (adhesions) had also started forming between his organs and tissues, as a result of inflammation. This can lead to numerous complications including breathing difficulties, chest pain, and decreased lung function.
The anonymous patient was diagnosed withpost-appendectomy hemomediastinum and authors on the man’s case believe this is the first reported incidence of such a complication.
As a result, he had to undergo another surgery where doctors made an incision through his chest wall to treat his lungs and the surrounding area.
During the operation they drained blood that had leaked from blood vessels and they removed any scar tissue.
In a report written by a team of surgeons from the Mayo Clinic in Eau Claire, Wisconsin, they confirmed that the patient’s condition stabilized following surgery.
He was then discharged in a ‘good condition’ 10 days later.
In the report, they note that the patient did have a number of health complaints prior to the incident.
He had a history of interstitial lung disease, a progressive condition that occurs when lung tissue becomes damaged and scarred, what’s known as fibrosis.
But his condition took a sharp decline following the removal of his appendix.
The team from Mayo Clinic note that spontaneous internal bleeding, particularly following an appendectomy, is ‘extremely uncommon and not typically associated with such procedures’.
However, they state that the case ’emphasizes the importance of early identification and timely intervention in managing this complication’ as it could prove fatal.
