[A case of intraoperative pulmonary embolism associated with lupus anticoagulant].
A 51-yr-old woman developed pulmonary embolism while undergoing surgery for breast cancer with Auchincloss method. General anesthesia was maintained with propofol and fentanyl. The course of anesthesia and operation were uneventful until the skin was sutured, when unexplained severe circulatory collapse developed. A widely dissociated EtCO2-PaCO2 suggested pulmonary embolism. The pulmonary circulation was restored 10 minutes after the start of heparin therapy, and the intravenous heparin administration was continued. The patient was extubated uneventfully 24 hours postoperatively. Lung perfusion scintigrams showed defect in right lower lungs (S 6, S 9). Venograms of the lower extremity disclosed thrombosis of the right popliteal vein. Furthermore, lupus anticoagulant was noted in the serum. Patients with antiphospholipid syndrome often develop pulmonary complications including pulmonary embolism and pulmonary hypertension. Intra-operative pulmonary embolism associated with lupus anticoagulant is a rare case.
Ootaki
C
C
Department of Anesthesia, Nishinomiya Municipal Central Hospital.
Uchida
T
T
Matsutani
R
R
Fukunaga
H
H
D000768:Anesthesia, General; D016736:Antiphospholipid Syndrome / Q000150:complications; D015415:Biomarkers / Q000097:blood; D001943:Breast Neoplasms / Q000601:surgery; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007431:Intraoperative Complications; D016682:Lupus Coagulation Inhibitor / Q000097:blood*; D008408:Mastectomy; D008875:Middle Aged; D019990:Perioperative Care; D011655:Pulmonary Embolism / Q000097:blood / Q000188:drug therapy / Q000209:etiology*
D015415:Biomarkers; D016682:Lupus Coagulation Inhibitor; D006493:Heparin