[A case report of complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma with pulmonary embolism of right lung after surgery for esophageal cancer].
A 54-year-old woman complained of dyspnea, due to complete obstruction of the left main bronchus caused by recurrent esophageal carcinoma, was transferred to our department about two months after curative resection (with preoperative chemotherapy for T4 cancer) in July 2004. She suddenly developed a severe shortness of breath with anxiety, and arterial blood gas analysis revealed a PaO2 of 25 mmHg (FiO2 1.0). The presence of pulmonary embolism was diagnosed by pulmonary perfusion scintigraphy. Thrombolytic therapy with urokinase was started to keep the air way. Fogarty catheter and bronchoscopic Nd-YAG laser treatment was performed. After that, an expandable metallic stent (EMS) was placed at the site of obstruction without any troubles, and there was a striking improvement in her condition of respiration and atelectasis. The radiation therapy was initiated and completed safely. The tumor lesion had disappeared on CT scan after the radiation therapy (a total dose of 50 Gy). We experienced a case that could be rescued from an advanced respiratory failure caused by one side air way obstruction and another side's blood circulation disorder.
Uemura
Mamoru
M
Dept. of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases.
Yano
Masahiko
M
Kishi
Kentaro
K
Takachi
Ko
K
Miyashiro
Isao
I
Noura
Shingo
S
Eguchi
Hidetoshi
H
Yamada
Terumasa
T
Ohue
Masayuki
M
Ohigashi
Hiroaki
H
Sasaki
Yo
Y
Ishikawa
Osamu
O
Shingi
Imaoka
I
D000402:Airway Obstruction / Q000209:etiology* / Q000628:therapy; D001982:Bronchial Diseases / Q000209:etiology* / Q000628:therapy; D004938:Esophageal Neoplasms / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D053685:Laser Therapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D015607:Stents; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D014568:Urokinase-Type Plasminogen Activator