Asai Katsuyuki, Mochizuki Takahiro, Iizuka Shuhei, Momiki Shigeru, Suzuki Kazuya
Division of Thoracic Surgery, Hamamatsu Medical Center, 328 Tomitsuka-cho, Naka-ku, Hamamatsu, Shizuoka, 432-8580, Japan,
Gen Thorac Cardiovasc Surg. 2014 Apr;62(4):244-7. doi: 10.1007/s11748-013-0229-1. Epub 2013 Mar 6.
We report a rare case of a pulmonary vein stump thrombus detected by a contrast-enhanced computed tomography for transient syncope 2 days after upper division segmentectomy of the left lung for metastatic pulmonary tumor. The thrombus disappeared without embolic events after anticoagulation with intravenous heparin followed by oral warfarin. Considering this case and previous reports, thoracic surgeons should be aware of pulmonary vein stump thrombus, a latent source of systemic embolization, after pulmonary resection, especially lobectomy or segmentectomy of the left upper lobe. This possible serious complication can occur at any time from the early postoperative period.
我们报告了一例罕见病例,一名患有转移性肺肿瘤的患者在接受左肺上叶段切除术后2天因短暂性晕厥行增强计算机断层扫描时发现肺静脉残端血栓形成。经静脉注射肝素抗凝,随后口服华法林治疗后,血栓消失,未发生栓塞事件。结合该病例及既往报道,胸外科医生应意识到肺切除术后,尤其是左上叶肺叶切除术或段切除术后,肺静脉残端血栓是全身栓塞的潜在来源。这种可能的严重并发症可在术后早期的任何时间发生。