A Case of Vena Cava Filter for Gastrointestinal Stromal Tumor Complicated by Pulmonary Thromboembolism

Eiji Meguro, Tooru Inaba, Takashi Irinoda, Yoshiroh Hayakawa, Shingo Okada and Hiroshi Kaizuka

Department of Surgery, Hakodate Goryoukaku Hospital

A 72-year-old woman with anorexia was suspected of abdominal phyma and admitted for detailed examination. Abdominal CT revealed a giant tumor with partial cystic changes compressing the stomach, pancreas, and spleen. Digestive tract endoscopy did not show any abnormalities in the gastric mucosa. Angiography showed that the phyma compressed the right gastric and gastric omental arteries in the lateral posterior direction, and splenic arteriography showed nutrient blood vessels from the branches of the splenic artery, that is, the short gastric artery, left gastric omental artery, and upper pole splenic artery. These findings suggested GIST, requiring surgery. Three days after angiography, dyspnea suddenly developed, and pulmonary blood flow scintigraphy confirmed bilateral pulmonary embolism. Before surgery, an inferior vena cava filter was inserted, and surgery was done under general anesthesia. The patient was managed without intraoperative or postoperative complications. In the present patient, angiography was considered an etiological factor; in patients with a history or risk of pulmonary embolism or deep venous thrombosis, however, an in-dwelling inferior vena cava filter may be useful for preventing perioperative pulmonary thromboembolism.

Key words
vena cava filter, pulmonary thromboembolism, preoperative management

Reprint requests
Eiji Meguro Department of Surgery, Hakodate Goryoukaku Hospital
38-3 Goryoukakucho, Hakodate, 040-8611 JAPAN

Accepted
April 28, 2004

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