横隔膜縫合糸断端による術後遅発性大量血胸

Delayed Massive Hemothorax due to Non-absorbable Sutures Tips Used in Diaphragm Reconstruction for Thymoma Dissemination

非吸収性縫合糸は生体内でも張力の劣化が少なく，心臓弁膜，筋肉，腱など持続的に抗張力が必要な部位に使用されているが，その縫合糸断端による臓器損傷もまれではあるが報告されている1）．われわれは，胸腺腫胸腔内再発に対する横隔膜部分切除・再建を非吸収糸で直接縫合を行ったが，その断端で肋間動脈を損傷し遅発性血胸をきたした1例を経験したので報告する．

A 57-year-old man underwent partial resection of the right diaphragm with invasive thymoma dissemination. Fifteen days after surgery, he suddenly developed right-sided chest pain with dyspnea and was raced to the hospital. Chest computed tomography （CT） showed a massive right hemothorax, and emergency surgery was performed due to hemodynamic shock. Thoracotomy revealed intercostal artery bleeding from a pinhole injury caused by a non-absorbable monofilament suture tip of the diaphragm. Hemothorax after thoracic surgery is a serious complication, and surgical materials with sharp edges may cause bleeding by contact with intrathoracic organs. Therefore, these materials should be used with caution and covered or cut as needed.