[症例報告]Umbilical hernia presented with postoperative pulmonary embolism : A case report and a review of the literature

概要

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Pulmonary embolism (PE) is a disease with a poor prognosis and common in western people. We experienced a case of PE after an operation for umbilical hernia. A 72-yearold woman whose height was 146 cm and weight was 78 kg, was referred to our hospital because of a soft mass (15×12×8 cm^3) in the umbilical region. Umbilical hernia was diagnosed with both physical examination and abdominal computed tomography. A radical operation was performed. On the 2nd postoperative day when she moved, she suddenly had dyspnea and fell into unconsciousness with hypoxemia. Multiple perfusional defects were revealed by a pulmonary blood flow scintigram, and the case was diagnosed as PE. We started thrombolytic and anticoagulant therapy with heparin and urokinase immediately. She was discharged from the hospital without sequelae on the 33rd postoperative day. It is thought that PE occurred due to deep vein thrombosis, increased intraabdominal pressure caused by the bowel returning into the abdominal cavity, tightening of the abdominal wall and obesity. If postoperative sudden onsets of dyspnea and unconsciousness with hypoxemia of unknown origin are encountered, examination and treatments should immediately be done keeping the presence of PE in mind.
琉球医学会の論文
2002-00-00