[A case of acute pulmonary embolism fourteen days after hysterectomy].
We describe a 54-year-old female with acute pulmonary embolism. She showed a syncope attack and hypotension fourteen days after hysterectomy for uterine cancer. Preoperative echocardiogram revealed that thrombus in the right atrium was coming and going through the tricuspid valve. Emergent pulmonary embolectomy through the sternotomy under cardiopulmonary bypass was performed 4.5 hours after the diagnosis without homologous blood transfusion. Postoperative perfusion scintigram 20 days after the operation showed normal filling of the both lungs except for the localized defect at the distal portion of the right middle lobe. The patient was discharged on the 22nd postoperative day and she has been followed up with anticoagulation therapy. It is essential that we have the opportunity to salvage an otherwise helpless situation by a high index of suspicion and a prompt surgical intervention.
Department of Cardiovascular Surgery, Toyama Prefectural Central Hospital, Japan.
Y
Y
Isomatsu
H
H
Tsukui
M
M
Hara
S
S
Hoshino
Y
Y
Nishiya
D000208:Acute Disease; D002315:Cardiopulmonary Bypass; D017128:Embolectomy; D004630:Emergencies; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011655:Pulmonary Embolism / Q000209:etiology / Q000601:surgery*; D012770:Shock, Cardiogenic / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery