Case Report: Occult splenic rupture during left-sided VATS decortication: diagnostic role of early perioperative FAST.

Video-Assisted Thoracic Surgery (VATS) is the preferred method for many thoracic diseases, featuring advantages of minimal trauma, reduced postoperative pain, and low complication rates. However, it carries potential risks, including splenic rupture-a rare but life-threatening complication. A 69-year-old male patient developed hemodynamic instability during VATS for left-sided empyema clearance; intraoperative exploration failed to identify an obvious bleeding source. Early post-procedural FAST bedside focused assessment with sonography for trauma (FAST) confirmed splenic rupture, which was managed promptly. The patient achieved full recovery and was discharged 17 days after surgery. Bedside FAST should be performed early when refractory shock occurs during VATS.