Fujimoto Yuri, Hamachi Ryosuke, Motoyama Yoshimasa, Kanna Etsuko, Murakami Masako, Matsukado Takako, Saito Genkichi, Yamaura Ken
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Anesthesia, Kyushu Central Hospital, 3-23-1, Shiobaru, Minami-ku, Fukuoka, 815-8588, Japan.
JA Clin Rep. 2021 Jan 6;7(1):4. doi: 10.1186/s40981-020-00407-7.
Cases of systemic thromboembolism due to thrombus formation in the pulmonary vein stump after lobectomy have been reported recently. Cerebral infarction after left upper lobectomy is a common symptom in these cases. We encountered a rare case of acute limb ischemia caused by a thrombus formed in the left inferior pulmonary vein stump after left lower lobectomy.
A 62-year-old man underwent video-assisted left lower lobectomy under general anesthesia with epidural anesthesia. On postoperative day 2, he suddenly developed pain in the left calf. Contrast-enhanced computed tomography showed left popliteal artery occlusion and thrombus formation in the left inferior pulmonary vein stump. Anticoagulant therapy was started immediately, and emergent endovascular thrombectomy was performed. The patient recovered without complications.
Left lower lobectomy can cause thrombus formation in the pulmonary vein stump, leading to systemic thromboembolism. Early detection and treatment are the keys to minimize complications.
近期有报道称，肺叶切除术后肺静脉残端血栓形成导致系统性血栓栓塞的病例。左上叶切除术后脑梗死是这些病例中的常见症状。我们遇到了一例罕见的左下叶切除术后左肺下静脉残端形成血栓导致急性肢体缺血的病例。
一名62岁男性在全身麻醉联合硬膜外麻醉下接受了电视辅助左下叶切除术。术后第2天，他突然出现左小腿疼痛。增强计算机断层扫描显示左侧腘动脉闭塞及左肺下静脉残端血栓形成。立即开始抗凝治疗，并进行了急诊血管内血栓切除术。患者康复且无并发症。
左下叶切除术可导致肺静脉残端血栓形成，进而引起系统性血栓栓塞。早期发现和治疗是将并发症降至最低的关键。
