Umemura Masanari, Ho David, Nozawa Naoki, Balginnyam Erdene, Iwatsubo Kousaku, Saito Toshihiko, Endo Tsutomu, Ishikawa Yoshihiro, Umemura Satoshi, Kimura Kazuo
Cardiovascular Research Institute, Department of Cell Biology and Molecular Medicine, New Jersey Medical School-University of Medicine and Dentistry of New Jersey, 185 South Orange Avenue, Newark, NJ 07103, USA.
Nozwa naika Jyunkankika, Yokohama, Japan.
J Cardiol Cases. 2011 Nov 21;5(1):e39-e43. doi: 10.1016/j.jccase.2011.10.004. eCollection 2012 Feb.
We report a rare case of acute pulmonary embolism (PE) induced by urinary retention and bladder distention with benign prostatic hyperplasia (BPH).
A 76-year-old male with BPH presented to the hospital with anuria of 24 h duration and abdominal distention. Physical examination revealed tenderness and distention of the lower abdomen and a swollen right leg. Echocardiography after urethral catheterization showed a large free-floating thrombus traversing back and forth through the tricuspid orifice. Computed tomographic angiography demonstrated filling defects at the level of the right inter lobar pulmonary artery and the segmental branches of both pulmonary arteries, indicating acute PE. The patient was treated with heparin and warfarin for three weeks to ensure the resolution of the pulmonary embolus. After the resolution of all symptoms, the patient was discharged without further complication.
This case suggested that a distended bladder is a potential risk factor for the development of deep vein thrombosis and PE.
我们报告一例由良性前列腺增生（BPH）导致的尿潴留和膀胱扩张引起的急性肺栓塞（PE）罕见病例。
一名患有BPH的76岁男性因持续24小时无尿及腹胀入院。体格检查发现下腹部压痛和膨隆，右腿肿胀。导尿术后的超声心动图显示一个大的游离漂浮血栓在三尖瓣口来回移动。计算机断层血管造影显示右肺叶间动脉水平及双肺段动脉分支处有充盈缺损，提示急性肺栓塞。患者接受肝素和华法林治疗三周以确保肺栓塞消散。所有症状缓解后，患者出院，无进一步并发症。
该病例提示膀胱扩张是深静脉血栓形成和肺栓塞发生的潜在危险因素。
