A Case of Intraoperative Pulmonary Thromboembolism after Having Set a Fractured Hip in a Cast while Traveling

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  • 旅行中の大腿骨骨折に対するギプス固定後，手術中に肺血栓塞栓症を発症した１症例

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Abstract

A 72-year-old woman fell down and fractured her right hip while traveling in Korea. The next day, the patient returned home by plane after about five hours traveling by car with the fractured hip immobilized in a cast.<br>Two days after her return, surgical treatment for the fractured femur was scheduled under spinal and epidural anesthesia. A decrease in oxygen saturation, hypotension, and loss of consciousness were seen while she underwent surgery for the fractured femur. We suspected acute pulmonary thromboembolism and performed pulmonary angiography. Its findings revealed multiple massive thrombi in bilateral pulmonary arteries. The patient was treated with anticoagulants including intravenous heparin. To prevent the recurrence of the pulmonary thromboembolism, a temporary IVC filter was inserted.<br>In conclusion, when the patient is likely to develop deep vein thrombosis, the possibility of pulmonary thromboembolism must be kept in mind and the preoperative examination and prevention against its occurrence must be performed so as not to threaten patient's life.

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