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Ann Thorac Surg 2002;74:258-261
© 2002 The Society of Thoracic Surgeons

Case report

Surgical staple metalloptysis after apical bullectomy: a reaction to bovine pericardium?

Mohammed F. Shamji, BS, MSa, Donna E. Maziak, MDCM, FRCSC*a, Farid M. Shamji, MBBS, FRCSCa, Frederick R.K. Matzinger, MDb, D. Garth Perkins, MDc

a Division of Thoracic Surgery, The Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada
b Department of Diagnostic Imaging, The Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada
c Department of Pathology, The Ottawa Hospital, Civic Campus, Ottawa, Ontario, Canada

Accepted for publication February 17, 2002.

* Address reprint requests to Dr Maziak, The Ottawa Hospital, Civic Campus, 1053 Carling Ave, CPC Rm 162, Ottawa, Ontario K1Y 4E9, Canada
e-mail: dmaziak{at}ohri.ca

Palliation of symptomatic emphysema may include bullous resection to improve function of the remaining lung. Buttressing staple lines with bovine pericardium partially alleviates postoperative air leak, but can promote inflammation and infection. We report a patient expectorating staples and pericardium 5 years after bilateral apical bullectomy. Previous reporting of this complication in lung volume reduction operation also involved both pericardium and staples, and we propose that an ongoing local inflammatory reaction to these materials may facilitate delayed erosion into airways.




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