Orthopedic pins and wires are regularly used for the treatment of bone fractures and dislocations. Migration of these devices from the shoulder into the thoracic cavity is an uncommon but well-known complication. However, great vessels' injuries by a migrated wire are extremely rare. We report the case of a 78-year-old woman with a penetrating injury of the ascending thoracic aorta and the superior vena cava caused by migration of a Steinman wire that was used for percutaneous fixation of a left-shoulder dislocation 5 years earlier. There was no hemothorax, hemomediastinum, or hemopericardia, but hemoptysis was present. Such a case has not been previously described. The patient was treated by an emergency median sternotomy with a favorable outcome.
Pleural effusion is not a commonly reported complication of appendicectomy. In our experience, we have performed all forms of appendicitis by laparoscopy (n = 217) since August 2006. We report three consecutive cases of right postoperative pleural effusion, all of which occurred during the immediate postoperative course of a laparoscopic appendicectomy. All three patients presented a perforated appendicitis. The right postoperative pleural effusions seem to be linked to the laparoscopic approach, and can be explained by the cumulative effects of peritoneal lavage, pneumoperitoneum and Trendelenburg position. The first two cases were managed medically by intravenous antibiotic therapy. The third patient required a pleural drainage by thoracoscopy. Surgeons should be aware of this complication when operating perforated appendicitis by the laparoscopic method.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.