An Acute Pulmonary Thoromboembolism Developed after Cholecystectomy -A Case Report-

Yoshihiro Masuko, Tsutomu Namieno, Norihiko Takahashi, Akihiko Gotoda, Narihiro Ooe*, Masatoshi Takahashi, Tsunemi Higashi*, Norimitsu Hasegawa*, Hajime Miyauchi*, Jun-ichi Uchino

First Department of Surgery, Hokkaido University School of Medicine
*Department of Surgery, Sapporo-Kosei General Hospital

A case of acute pulmonary thromboembolism after cholecystectomy is reported. A 64-year-old woman developed hypoxia (PAo₂ 31.6 mmHg) and low blood pressure (50 mmHg) the day after the operation. Because from the physical examinations she was suspected of having a pulmonary thrombosis, she was immediately given thrombolytic and anticoagulant therapy: urokinase 2.4×10⁵/day and heparin 2.0×10⁴/day, and then the pulmonary arteriography showed a pulmonary embolism. Thrombolytic therapy was effective and her clinical course proceeded favorably: her extubation was done on the 4th postoperative day and the injection of urokinase was stopped on the 10th postoperative day. Although thrombolytic and anticoagulant treatment soon after an operation may cause a critical condition, it must not be avoided when a patient's condition is serious. The incidence of pulmonary embolism will increase with our Western life style. This disease should be considered as one of the critical complications after enterological surgery. A good prognosis would be provided by early thrombolytic therapy, when a pulmonary embolism is suspected.

Key words
pulmonary thromboembolism, cholecystectomy

Reprint requests
Yoshihiro Masuko First Department of Surgery, Hokkaido University School of Medicine
N-15, W-7, Kita-ku, Sapporo, 060 JAPAN

Accepted
September 9, 1992

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