Yu Zhimin, Deng Heran, Wang Jie, Xu Junyao
Department of hepatobiliary surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, #33 Ying feng Road, Guangzhou, P. R. China, 510120.
Department of breast surgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, P. R. China, 510120.
BMC Surg. 2020 Jul 8;20(1):148. doi: 10.1186/s12893-020-00798-5.
Paradoxical embolism (PDE) presented with concomitant pulmonary embolism (PE) and renal artery embolism (RAE) which occurred to breast cancer patient after breast-conserving therapy, has never been reported.
A 55-year-old female with breast cancer exhibited unexplained hypoxemia, followed with vomiting, diarrhea, unilateral flank pain and abdominal pain after lumpectomy 12 h. The urgent multi-detector row computed tomography (MDCT) confirmed the diagnosis of PE and RAE. Confusingly, the patient had no history of intracardiac defect, cardiac valvular diseases, atrial fibrillation or other cardiovascular disease and the definite cause was still unclear. However, after 10 days of prompt anticoagulant therapy in ICU, she was discharged in good condition.
Breast cancer patients after surgery suffering from unexplained hypoxemia, abdominal pain, vomiting and diarrhea should be highly suspicious of PE or RAE, even PDE. Any clinical presentation on these postoperative patients should be given much more attention to make accurate diagnosis and appropriate interventions.
矛盾栓塞（PDE）表现为在保乳治疗后乳腺癌患者同时出现肺栓塞（PE）和肾动脉栓塞（RAE），此前从未有过相关报道。
一名55岁乳腺癌女性患者在肿块切除术后12小时出现不明原因的低氧血症，随后出现呕吐、腹泻、单侧胁腹疼痛和腹痛。紧急多层螺旋计算机断层扫描（MDCT）确诊为PE和RAE。令人困惑的是，该患者无心脏内缺损、心脏瓣膜疾病、心房颤动或其他心血管疾病史，确切病因仍不明确。然而，在重症监护病房（ICU）进行10天的及时抗凝治疗后，她康复出院。
乳腺癌术后患者若出现不明原因的低氧血症、腹痛、呕吐和腹泻，应高度怀疑PE或RAE，甚至PDE。对于这些术后患者的任何临床表现都应给予更多关注，以便做出准确诊断并采取适当干预措施。
