Pulmonary embolism and cerebral venous thrombosis after thoracoscopic surgery for benign pulmonary disease.
A-76-year-old woman consulted for open biopsy for a pulmonary mass. Thoracoscopic wedge resection was performed. The lesion was histologically diagnosed as nonspecific inflammation. On the first postoperative day (POD1), the patient lost consciousness transiently. Eleven hours after the first stroke, the patient experienced a second stroke together with hypoxia. Pulmonary perfusion scan on POD2 showed multiple perfusion defects, and the patient was diagnosed with pulmonary embolism (PE). Thrombolitic therapy was started. Neurological symptoms didn't improve, and cerebral angiography on POD3 showed delayed perfusion in superficial veins. The patient was diagnosed with cerebral venous thrombosis (CVT). Thrombolytic and anticoagulant therapy had been continued, and the patient was found to have hemorrhagic cerebral infarction on POD11. After persistent therapy, the patient was discharged on POD120. Although both PE and CVT are rare complications after thoracic surgery, we must consider these complications in patients undergoing thoracic operations including thoracoscopic surgery.
Sakai
Takehiro
T
Department of Surgery, Aomori Rosai Hospital, 1-Minamigaoka, Shirogane-machi, Hachinohe 031-8551, Japan. t-sakai@cc.hirosaki-u.ac.jp
Ogura
Yuta
Y
Kimura
Daisuke
D
Narita
Junichi
J
Suto
Takemichi
T
Fukuda
Ikuo
I
D000368:Aged; D001706:Biopsy; D001921:Brain / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000473:pathology; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology* / Q000628:therapy; D020225:Sagittal Sinus Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D019616:Thoracic Surgical Procedures / Q000009:adverse effects*; D013906:Thoracoscopy / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome