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- Title
Massive pulmonary embolism and intra-cardiac thrombus requiring systemic thrombolysis 9-hours post emergency laparotomy.
- Authors
Simpson, Fraser Hugh; Chandrasegaram, Manju D
- Abstract
The link between abdominal surgery and venous thromboembolism (VTE) has been well established with recent evidence exploring the optimal VTE risk reducing strategy. However, despite these strategies pulmonary embolisms (PEs) do occur, which in the immediate post-operative setting creates a dilemma; to treat the VTE with anticoagulation but balance against the risk of hemorrhage. Treatment guidelines often do not include post-operative patients leaving the decision up to the treating physician to weigh the relative risks on an individual basis. We present a 59-year-old lady who developed a life-threatening submassive PE within 9 h of an emergency laparotomy for a perforated rectal cancer. She was treated with systemic thrombolysis after alternative interventions had been excluded. She responded well to therapy with no major bleeding. She was successfully discharged home after a short period of inpatient rehabilitation.
- Subjects
PULMONARY embolism; THROMBOSIS; ABDOMINAL surgery; THROMBOEMBOLISM; RECTAL cancer; THROMBOLYTIC therapy
- Publication
Journal of Surgical Case Reports, 2022, Vol 2022, Issue 11, p1
- ISSN
2042-8812
- Publication type
Case Study
- DOI
10.1093/jscr/rjac528