Life-threatening hemorrhage during removal of a Nuss bar embedded in the sternum: a case report.

BACKGROUND: Plate erosion of the sternum leading to hemorrhage during NUSS bar removal procedure for pectus excavatum is a very rare complication, and the few cases reported worldwide are currently only briefly described in the statistical results. CASE PRESENTATION: A 22-year-old female patient underwent a surgical repair for pectus excavatum(Nuss procedure)2.5 years ago. During the removal of the bars in our center, we found that there was great resistance when removing the upper Nuss bar, and a rapid flow of bright red hemorrhage flowed from both incisions immediately after removal. A longitudinal sternotomy confirmed that the plate had eroded into the sternum and damaged the internal thoracic artery during removal. CONCLUSION: We should pay attention to the interpretation of preoperative images before the removal of orthopedic plates for pectus excavatum, and the correct preoperative preparation and intraoperative strategy can help to reduce the incidence of hemorrhage.