Kuwada Masaomi, Hosokawa Yukinari, Yoshikawa Motokiyo, Takada Satoshi, Kumamoto Hiromi, Hayashi Yoshiki, Oyama Nobuo, Fujimoto Kiyohide, Hirao Yoshihiko
The Department of Urology, Tane General Hospital.
Hinyokika Kiyo. 2010 Jan;56(1):17-20.
A 65-year old woman underwent retroperitoneoscopic nephrectomy, for left renal mass which was suspected to be renal cell carcinoma. On the 2nd postoperation day, she suddenly complained of dyspnea and chest pain. Enhanced computed tomography revealed a defect of peripheral pulmonary artery, and ventilation-perfusion lung scanning showed large defect of the uptake in bilateral lung fields. Based on the arterial blood gas and imagings, she was diagnosed with a PTE (pulmonary thromboembolism). Thrombolytic therapy and anti-coagulant therapy were started. Thereafter, she recovered from hypoxia. However, these therapies gave rise to postoperative hemorrhage resulting in a massive retroperitoneal hematoma.
一名65岁女性因左肾肿物疑为肾细胞癌而接受了后腹腔镜肾切除术。术后第2天,她突然出现呼吸困难和胸痛。增强计算机断层扫描显示外周肺动脉缺损,通气-灌注肺扫描显示双侧肺野摄取大量缺损。根据动脉血气和影像学检查,她被诊断为肺血栓栓塞症(PTE)。开始进行溶栓治疗和抗凝治疗。此后,她的缺氧症状得到缓解。然而,这些治疗引发了术后出血,导致大量腹膜后血肿。