Perioperative management of a patient with deep vein thrombosis caused by estrogen producing granulosa cell tumor of the ovary

Naoko Nakaigawa, Ryu Komatsu, Keiko Hamada, Kotoe Kamata, Makoto Ozaki

研究成果: Article査読

抄録

We experienced perioperative management of a woman with large thrombi in femoral veins caused by estrogen producing ovarian tumor. At presentation, serum estradiol level was extremely high. Time constraint due to rapid expansion of the tumor did not allow us a trial of preoperative anti-coagulation. We placed a temporary IVC filter and proceeded with operation. As catastrophic pulmonary embolism could occur even with the presence of a filter, we prepared for institution of cardiopulmonary bypsss and pulmonary embolectomy via full sternotomy. We monitored arterial pressure based-cardiac output for immediate detection of pulmonary embolism. Postoperatively, serum estradiol level declined to normal range by post-operative day 7, and thrombi dissolved with anticoagulation therapy with warfarin and heparin without recurrence. In this case, surgery without preoperative anticoagulation was considered to pose extreme risk of perioperative pulmonary embolism. However, we considered that the thrombi would disolve by the removal of the tumor because estradiol production was the primary cause of thrombi. With above mentioned perioperative approach, the patient was managed uneventfully.

本文言語English
ページ(範囲)224-227
ページ数4
ジャーナルJapanese Journal of Anesthesiology
59
2
出版ステータスPublished - 2010 2 1
外部発表はい

ASJC Scopus subject areas

  • 麻酔学および疼痛医療

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