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Intravascular Pulmonary Migration of a Subdermal Contraceptive Implant
Intravascular Pulmonary Migration of a Subdermal Contraceptive Implant Xavier Benoit D’Journo, MD, PhD, Vincent Vidal, MD, PhD, and Aubert Agostini, MD, PhD ˇ
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Service de Chirurgie Thoracique, Hopital Nord; Service de Radiologie, Hopital de la Timone, and Service de Gyn ecologie-Obst etrique, e, Marseille France Hopital La Conception, Aix-Marseille Universit
FEATURE ARTICLES
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Fig 1.
A
20-year-old woman experienced regular metrorrhagia few weeks after she received an etonogestrel subdermal implant in the left arm. Fifteen days after implantation, the implant was clinically not detectable. Blood measures revealed a high-level of etonogestrel.
Address correspondence to Dr D’Journo, Service de Chirurgie Thoracique, Aix-Marseille Universite, Hopital Nord, Chemin des Bourrely, 13915 Marseille cedex, France; e-mail: [email protected]. ˇ
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
A chest roentgenogram (Fig 1A; left, anteroposterior view; right, lateral view) and a 3-dimensional volumerendered computed tomography scan of the chest (Fig 1B) confirmed the migration of the implant in a branch of the left common basal pulmonary artery. Because the implant was too distal for a transluminal extraction, the patient was referred for surgical intervention. She underwent a left basal trisegmentectomy under video-assisted thoracoscopy (Fig 1C). Her postoperative outcome was uneventful.
Ann Thorac Surg 2015;99:1828 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.12.049
ˇ
Service de Chirurgie Thoracique, Hopital Nord; Service de Radiologie, Hopital de la Timone, and Service de Gyn ecologie-Obst etrique, e, Marseille France Hopital La Conception, Aix-Marseille Universit
FEATURE ARTICLES
ˇ
Fig 1.
A
20-year-old woman experienced regular metrorrhagia few weeks after she received an etonogestrel subdermal implant in the left arm. Fifteen days after implantation, the implant was clinically not detectable. Blood measures revealed a high-level of etonogestrel.
Address correspondence to Dr D’Journo, Service de Chirurgie Thoracique, Aix-Marseille Universite, Hopital Nord, Chemin des Bourrely, 13915 Marseille cedex, France; e-mail: [email protected]. ˇ
Ó 2015 by The Society of Thoracic Surgeons Published by Elsevier
A chest roentgenogram (Fig 1A; left, anteroposterior view; right, lateral view) and a 3-dimensional volumerendered computed tomography scan of the chest (Fig 1B) confirmed the migration of the implant in a branch of the left common basal pulmonary artery. Because the implant was too distal for a transluminal extraction, the patient was referred for surgical intervention. She underwent a left basal trisegmentectomy under video-assisted thoracoscopy (Fig 1C). Her postoperative outcome was uneventful.
Ann Thorac Surg 2015;99:1828 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.12.049