Chest
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A 36-year-old male with no significant medical history presented to the ED with progressive left-sided neck and facial pain for the last 7 days. The patient also reported subjective fevers, chills, difficulty opening his mouth, and anorexia for the last 1 week. ⋯ There was no recent travel or sick contact exposure. He did not report any TB exposure, IV drug use, or recent sexual encounters.
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This novel report presents the first known case, to our knowledge, of a 16-year-old male patient who experienced intraventricular thrombosis and pulmonary embolism after a Nuss procedure for pectus excavatum, attributed to chronic bar displacement. Two years after the operation, the patient experienced post-exercise cough and hemoptysis, which led to his admission. Imaging revealed pulmonary embolism, thrombosis in the right ventricular outflow tract, and lung infiltrative lesions. ⋯ Surgery revealed the bars' intrusion into the right ventricle and lung. This case highlights the risk of severe complications from bar displacement in the Nuss procedure, which necessitates long-term follow-up evaluation, caution against strenuous activities after surgery, and use of thoracoscopic guidance during bar implantation and removal. It underscores the importance of vigilant evaluation for late-stage complications in patients with respiratory distress or thrombosis after a Nuss procedure.