Report of Three Cases of Acute Pulmonary Embolism after Gastrointestinal Surgery

DOI 13 References
  • Yamanouchi Satoshi
    Department of Emergency and Critical Care Medicine, Iwaki Kyoritsu General Hospital
  • Arai Masatoku
    Department of Emergency and Critical Care Medicine, Iwaki Kyoritsu General Hospital
  • Koyama Atsushi
    Department of Emergency and Critical Care Medicine, Iwaki Kyoritsu General Hospital
  • Azuma Kazuaki
    Department of Emergency and Critical Care Medicine, Iwaki Kyoritsu General Hospital
  • Maki Masahiko
    Department of Emergency and Critical Care Medicine, Iwaki Kyoritsu General Hospital
  • Shinya Fumiaki
    Department of Surgery, Iwaki Kyoritsu General Hospital

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Other Title
  • 消化器外科手術後に発症した急性肺動脈塞栓症の３症例

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Abstract

The incidence of acute pulmonary embolism (APE) has been increasing in Japan. We report 3 cases of APE after gastrointestinal surgery from January 1999 to December 2002. The latest was treated with compression stockings and intermittent pneumatic compression to prevent APE. One patient suffering from massive brain infarction died of a cerebral hernia. We saved 2 patients, one treated with catheter intervention under percutaneous cardiopulmonary support (PCPS) and another treated with anticoagulation after the insertion of an inferior vena cava filter. Gastrointestinal surgery patients have many clinical risk factors, such as prolonged immobility, cancer, surgery involving the pelvis, and pneumoperitoneum caused by laparoscopic surgery. The diagnosis of pulmonary embolism remains difficult, because its symptoms and clinical findings are not necessarily specific. We must therefore consider APE as a critical complication after gastrointestinal surgery. It is important to introduce PCPS immediately in the seriously ill, and to simultaneously maintain the patients breathing and circulation.

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