Akademik Veri Yönetim Sistemi
Dicle Tıp Dergisi, cilt.52, sa.4, ss.729-735, 2025 (TRDizin)
Background: Hemothorax represents a rare but serious complication after posterior correction surgery (PCS) for spinal deformities, occurring in roughly 0.1% of cases. When diagnosis is delayed or the condition is missed, the clinical consequences can be severe. In this retrospective review, we evaluated pediatric patients who developed hemothorax after PCS, aiming to describe the perioperative diagnostic difficulties and management experiences encountered. Methods: From 2016 to 2021, we retrospectively reviewed the records of 135 children who underwent posterior correction surgery for spinal deformity. Five of these patients were diagnosed with postoperative hemothorax and were included in the study. The variables assessed comprised demographic information, intraoperative imaging findings, the onset of hemodynamic deterioration, and the treatments applied. Results: The mean patient age at the time of surgery was 12.4 ± 2.9 years. Intraoperative posteroanterior chest radiographs were routinely obtained to confirm the placement of spinal instrumentation. A retrospective review of these films showed clear signs of hemothorax in four children and suspicious findings in one. None of the cases received intraoperative intervention for hemothorax. Because of subsequent hemodynamic instability, all five were transferred from the ward to the intensive care unit at different times after surgery. Chest tube drainage was required in three patients, thoracentesis in one, and surgical decortication in another. Conclusion: Early recognition of hemothorax plays a key role in preventing postoperative complications. For patients considered at higher risk, intraoperative bedside thoracic ultrasonography should be routinely employed. When this option is not accessible, performing a chest X-ray in the reverse Trendelenburg position before extubation may help reduce the likelihood of a missed diagnosis