We report the case of a 70-year-old man who developed a splenic infarction due to a thrombus in the pulmonary vein (PV) stump after left upper lobectomy (LUL). Preoperative imaging showed a mass measuring > 5 cm in the upper lobe of the left lung, and sputum cytology revealed squamous cell carcinoma. Therefore, video-assisted thoracoscopic LUL was performed. The postoperative course was uneventful but biochemical blood tests showed an increased inflammatory response. Contrast-enhanced computed tomography revealed splenic infarction and a thrombus in the left superior PV stump. Prompt treatment with anticoagulants was administered, and the patient was discharged with mild recovery. However, the patient developed cerebral infarction after discharge and died 33 days after the surgery. Splenic infarction is a rare postoperative complication, with only three reported cases, including this report. However, this condition should be considered along with PV thrombus when evaluating an increased inflammatory response after LUL.

我们报告了一名 70 岁男性的病例，他在左上肺叶切除术 (LUL) 后因肺静脉 (PV) 残端血栓而发生脾梗死。术前影像显示左肺上叶肿块 > 5 cm，痰细胞学显示鳞状细胞癌。因此，进行了电视胸腔镜LUL。术后过程很顺利，但生化血液检查显示炎症反应增加。对比增强计算机断层扫描显示左上 PV 残端有脾梗死和血栓。及时给予抗凝剂治疗，患者轻度康复出院。但患者出院后出现脑梗塞，术后33天死亡。脾梗死是一种罕见的术后并发症，仅报告了三个案例，包括本报告。然而，在评估 LUL 后炎症反应增加时，应将这种情况与 PV 血栓一起考虑。