Case of a Patient Undergoing Colon Cancer Surgery in Whom Plasma Soluble Fibrin Monomer Complex Measurement Proved Useful for the Diagnosis of Pulmonary Embolism
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- Mochizuki Tetsuya
- Department of Surgery, Chugoku Rosai Hospital
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- Hirata Yuzo
- Department of Surgery, Chugoku Rosai Hospital
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- Sato Kouki
- Department of Surgery, Chugoku Rosai Hospital
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- Sakimoto Hideto
- Department of Surgery, Chugoku Rosai Hospital
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- Eto Takaaki
- Department of Surgery, Chugoku Rosai Hospital
Bibliographic Information
- Other Title
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- 大腸癌周術期発症の肺血栓塞栓症診断に可溶性フィブリンモノマー複合体(SFMC)測定が有用であった1例
Description
<p>We encountered a case in which soluble fibrin monomer complex (SFMC) measurement in the plasma was useful for the diagnosis of perioperative critical pulmonary thromboembolism (PTE). A man in his 70s with a high fever and weakness of the limbs was referred to our hospital. Blood tests showed elevated levels of creatine phosphokinase. The patient was diagnosed as having an infection of unknown origin with rhabdomyolysis. Whole-body computed tomography (CT) revealed thickening of the wall of the ascending colon. Colonoscopy showed an elevated lesion in the ascending colon. Endoscopic biopsy specimens revealed the diagnosis of colonic adenocarcinoma. Based on these findings, a diagnosis of ascending colon cancer was made, and right hemicolectomy was scheduled. During induction of anesthesia for the surgery, the blood pressure and peripheral arterial oxygen saturation suddenly decreased. The surgery was, however, continued as the blood pressure and oxygen saturation improved with blood transfusion and catecholamine infusion. A blood test revealed elevation of the plasma SFMC level to 129.8μg/mL (reference value ≤7.0μg/mL), and acute pulmonary embolism was suspected. However, transesophageal echocardiography did not reveal either severe right ventricular hypokinesis or persistent pulmonary hypertension. Postoperative measurement revealed further elevation of the SFMC level (361.6μg/mL);therefore, emergency CT was performed, which revealed pulmonary embolism and left femoral vein thrombosis. An inferior vena cava (IVC) filter was placed immediately. Anticoagulant therapy was started from the day after the surgery. The IVC filter was removed after 2 weeks, and the patient was discharged on day 31 after the operation. This case report indicates the usefulness of plasma SFMC measurement for early diagnosis of PTE in perioperative patients.</p>
Journal
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- Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)
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Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) 36 (7), 1243-1247, 2016
Japanese Society for Abdominal Emergency Medicine
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Keywords
Details 詳細情報について
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- CRID
- 1390282679715459712
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- NII Article ID
- 130005462648
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- ISSN
- 18824781
- 13402242
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- Text Lang
- ja
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- Data Source
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- JaLC
- CiNii Articles
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- Abstract License Flag
- Disallowed