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Background <p>Posterior correction surgery for adolescent idiopathic scoliosis (AIS) carries a risk of rare, life-threatening complications. We present a case of massive tension hemothorax following AIS surgery, highlighting the diagnosis and management challenges.</p> Case description <p>A 14-year-old girl with AIS (82° thoracic curve) underwent posterior correction and fusion surgery from T3 to L1. Intraoperative bleeding was approximately 800&#xa0;ml. Shortly after extubation, the patient developed acute respiratory distress and hypotension. Examination and chest radiography confirmed a left-sided tension hemothorax. An emergent thoracentesis drained about 5000&#xa0;ml of blood. Angiography failed to identify the bleeding source, necessitating urgent thoracotomy. The bleeding site, located at the 3rd left intercostal space, was successfully controlled via endoscopic cauterization.</p> Conclusions <p>This case underscores that tension hemothorax, though rare, requires high clinical suspicion. Unexplained hypotension during or after AIS correction surgery should prompt immediate investigation. When minimally invasive intervention fails, urgent exploration is essential and can be life-saving.</p>

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Urgent thoracotomy for thoracic hemorrhage after posterior correction surgery in adolescent idiopathic scoliosis: case report and literature review

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月17日

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  • Hifza Babar,
  • Dong Xie,
  • Yuanyuan Dong,
  • Xiaodong Qin,
  • Saihu Mao,
  • Zhen Liu,
  • Zezhang Zhu,
  • Yong Qiu

摘要

Background

Posterior correction surgery for adolescent idiopathic scoliosis (AIS) carries a risk of rare, life-threatening complications. We present a case of massive tension hemothorax following AIS surgery, highlighting the diagnosis and management challenges.

Case description

A 14-year-old girl with AIS (82° thoracic curve) underwent posterior correction and fusion surgery from T3 to L1. Intraoperative bleeding was approximately 800 ml. Shortly after extubation, the patient developed acute respiratory distress and hypotension. Examination and chest radiography confirmed a left-sided tension hemothorax. An emergent thoracentesis drained about 5000 ml of blood. Angiography failed to identify the bleeding source, necessitating urgent thoracotomy. The bleeding site, located at the 3rd left intercostal space, was successfully controlled via endoscopic cauterization.

Conclusions

This case underscores that tension hemothorax, though rare, requires high clinical suspicion. Unexplained hypotension during or after AIS correction surgery should prompt immediate investigation. When minimally invasive intervention fails, urgent exploration is essential and can be life-saving.