Acute limb ischemia by a pulmonary vein stump thrombus after left lower lobectomy: a case report.

Autor: Fujimoto Y; Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. 3md20032g@kyudai.jp., Hamachi R; Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Motoyama Y; Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Kanna E; Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Murakami M; Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Matsukado T; Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Saito G; Department of Surgery, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan., Yamaura K; Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Jazyk: angličtina
Zdroj: JA clinical reports [JA Clin Rep] 2021 Jan 06; Vol. 7 (1), pp. 4. Date of Electronic Publication: 2021 Jan 06.
DOI: 10.1186/s40981-020-00407-7
Abstrakt: Background: Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy.
Case Presentation: A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications.
Conclusions: Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.
Databáze: MEDLINE
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