Hemoptysis and coughing up of staples as a late complication of volume reduction surgery for emphysema

Three patients with very similar clinical symptoms, i.e. hemoptysis and coughing up of staples some time after volume-reducing surgery, are described. There was no deterioration in lung function, nor in the patient's well-being, which could be ascribed to the coughing up of the staples. Thus, staples can some time after volume reducing surgery erode out into the bronchi and be coughed up, often with some small amounts of blood. This has no clinical significance other than the disturbing symptoms. Possibly, the calf pericardium used as strenghtener of the suture lines wilt with time cause an immunological reaction, causing destruction of the foreign material and thereby dislodging the staples. (c) 2005 Elsevier Ltd. All rights reserved.