Cardiac herniation following intrapericardial pneumonectomy in an advanced lung cancer patient with intractable lung abscess

Abstract

This is a case report of cardiac herniation following right lower lobe lobectomy in a non-small-cell lung cancer patient who previously underwent right upper lobe and right middle lobe lobectomies. The patient presented with obstructive shock with refractory hypoxemia at the 8th hour after the lobectomy with radical removal of the tumor and complicated lung abscess via intrapericardial approach. Chest radiography showed cardiac displacement to the right hemithorax. Cardiac herniation was diagnosed. Consequently, emergency rethoracotomy was performed to explore the cause of this complication and reduce the heart to the normal position. A large pericardial defect was found and subsequently closed by pericardial patch.