A CASE OF PULMONARY EMBOLISM EPISODE INSERTED IVC FILTER FOR PREVENTION OF RECURRENCE AT RE-OPERATION

Abstract

We report a case of rectal cancer with intraoperative pulmonary embolism, who was successfully performed re-operation under an insertion of IVC filter. A 72-year-old man was admitted to the hospital because of anal bleeding. Further examination shows a rectal cancer with liver metastasis. During operation when freeing rectosigmoid colon from the retroperitoneum was conducting, the patient suddenly developed respiratory distress including hypoxia that was not improved. So, the operation was terminated after sigmoid colostomy with a diagnosis of pulmonary embolism. A gradual remission of the respiratory condition was achieved. Postoperative ventilation-perfusion scanning of the lung showed pulmonary embolism of the right lower lung field. Urokinase and heparin were administered. Under preoperative insertion of IVC filter, the second operation was performed uneventfully. If the patients has an episode of pulmonary embolism or deep venous thrombosis, it is a useful method for prevention of pulmonary embolism to insert IVC filter preoperatively.