Oura Hiroyuki, Hirose M, Aikawa H, Ishiki M
Department of Thoracic Surgery, Iwate Prefectural Central Hospital, Morioka, Japan.
Kyobu Geka. 2005 Feb;58(2):137-42.
Very rare cases of abdominal organ infarction after surgery of primary lung cancer were reported. Case 1: Patient 1 was a 70-year-old man who underwent left upper lobectomy and ND 2a in June 1999 based on the clinical diagnosis of stage IA lung cancer. On the 4th postoperative day, the patient developed fever and right flank pain. Abdominal computed tomography (CT) demonstrated a specific finding compatible with renal infarction. The etiology could not be determined. The patient was treated conservatively. However, severe atrophy of right kidney was demonstrated by following CT performed 3 years later. Case 2: Patient 2 was a 70-year-old woman who underwent left upper lobectomy and ND 2a in December 2002 based on the clinical diagnosis of stage IA lung cancer. On the 4th postoperative day, the patient developed abdominal pain in the left upper quadrant, nausea and vomiting which had lasted for 10 days. Abdominal CT demonstrated a wedge-shaped filling defect at spleen compatible with splenic infarction. The etiology could not be determined. The patient was treated conservatively with prophylactic antibiotic therapy and followed closely. Partial atrophy of spleen was demonstrated by following CT performed 4 months later.
有报道称,原发性肺癌手术后发生腹部器官梗死的病例极为罕见。病例1:患者1为一名70岁男性,基于IA期肺癌的临床诊断,于1999年6月接受了左上叶切除术及2a组淋巴结清扫术。术后第4天,患者出现发热及右侧胁腹疼痛。腹部计算机断层扫描(CT)显示出与肾梗死相符的特异性表现。病因无法确定。患者接受了保守治疗。然而,3年后进行的后续CT检查显示右肾严重萎缩。病例2:患者2为一名70岁女性,基于IA期肺癌的临床诊断,于2002年12月接受了左上叶切除术及2a组淋巴结清扫术。术后第4天,患者出现左上腹疼痛、恶心和呕吐,持续了10天。腹部CT显示脾脏有一个楔形充盈缺损,与脾梗死相符。病因无法确定。患者接受了预防性抗生素治疗的保守治疗,并密切随访。4个月后进行的后续CT检查显示脾脏部分萎缩。