2021 Volume 35 Issue 6 Pages 724-730
The common complications after preoperative computed tomography-guided localization are pneumothorax and intrapulmonary hemorrhage. Air embolism is known as a rare but potentially fatal complication. We report two cases of short hook wire with nylon thread (marker) migration into the digestive tract through the bronchus. Case 1: The marker was placed on the day before surgery for a nodule in the left upper lobe. A chest radiograph taken after marking showed a slight pneumothorax. Although we could not find the marker in the thoracic cavity during surgery, we performed partial resection, because the nodule was palpable. Computed tomography revealed the marker in the descending colon. On the third postoperative day, it was found in the stool. Case 2: The marker was placed on the day before surgery for a nodule in the right middle lobe. A chest radiograph taken after the procedure showed no marker. We performed emergent computed tomography and located the marker in the small intestine. On the next day, surgery was performed as scheduled. The nodule was palpable; therefore, we initially performed partial resection. As the intraoperative pathological diagnosis was adenocarcinoma, we performed middle lobectomy. On the third postoperative day, an abdominal radiograph could not detect the marker. Because computed tomography could not reveal the marker in the colorectum on the fourth postoperative day, we considered that it had been discharged from body. In the two cases, the markers were expectorated through the bronchus and migrated into the digestive tract by unconscious swallowing. When performing computed tomography-guided localization, we should avoid peripheral bronchus and fix a nylon thread attached to a marker to the skin.
