A hook wire dislodged into the subglottic area as a rare complication following computed tomography-guided hook wire localization: a case report

Abstract

Background: Computed tomography-guided hook wire localization (CT-GHWL) was used to localize the small pulmonary nodules before video-assisted thoracic surgery (VATS). Its associated complications included hook wire dislodgement, pulmonary hemorrhage, and pneumothorax. This is the first report of a patient with a hook wire sliding into the subglottic area after CT-GHWL. Case presentation: A 27-year-old female had productive cough for 8 days. A high-resolution CT scan showed a 12 mm part-solid nodule in the number 8 segment of the left lung. Prior to VATS, she received CT-GHWL to localize the nodule. During VATS, the hook wire unexpectedly slid away. A chest computed tomography was immediately performed and the sagittal reconstructed images showed the needle at the subglottic area. Finally, the needle was extracted by biopsy forceps under bronchoscope evaluation. The patient was eventually recovered and discharged. Conclusions: Dislodge of the hook wire into the subglottic area is an extremely rare but serious complication following CT-GHWL. Attention should be paid to securing the needle on the lung surface during VATS.