Journal of Digestive Cancer Research

Korean Society of Gastrointestinal Cancer Research (대한소화기암연구학회)
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A Case of Advanced Gastric Cancer with Deep Vein Thrombosis Treated with Low Molecular Weighted Heparin

전이성 위암환자의 심부정맥혈전증에 대한 저분자량 헤파린 투여 사례

  • Su Jin Heo (Department of Gastroenterology, Yonsei University College of Medicine) ;
  • Chan Hyuk Park (Department of Gastroenterology, Yonsei University College of Medicine) ;
  • Sang Kil Lee (Department of Gastroenterology, Yonsei University College of Medicine)
  • 허수진 (연세대학교 의과대학 내과학교실) ;
  • 박찬혁 (연세대학교 의과대학 내과학교실) ;
  • 이상길 (연세대학교 의과대학 내과학교실)
  • Received : 2013.09.04
  • Accepted : 2013.10.24
  • Published : 2013.11.30
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Abstract

The relationship between malignancy and venous thromboembolism(VTE) has been well established. About 20% of all VTE cases are associated with cancer and thrombotic events are the second leading cause of death in cancer patients after death from cancer itself. Effective prophylaxis and treatment will reduce morbidity and may decrease overall mortality. We report a case of VTE in a patient with advanced gastric cancer who treated with low-molecular weighted heparin (LMWH). A 49-year-old man with heartburn was admitted to our hospital. On the endoscopic and radiologic imaging, the patient was diagnosed as an advanced gastric cancer with perigastric infiltration and liver metastasis. During the combination chemotherapy, he had pain and swelling of left lower leg. Doppler ultrasonography showed left posterior tibial venous thrombosis and pulmonary embolism CT showed thromboembolism in subsegmental pulmonary artery branch in right lower lobe. He was treated with LMWH, Dalteparin once daily via subcutaneous injection, and his symptoms was subsided.

전체 정맥혈색전증 환자의 20% 이상이 암과 관련이 있고, 암 환자에 있어 혈색전증은 두 번째 사망 원인으로 작용하고 있어 이에 대한 효과적인 예방과 치료가 사망률을 감소시킬 수 있는 것으로 알려져 있다. 혈색전증 진단에 있어 혈액검사로 D-dimer 측정 및 영상검사로 도플러 초음파, 전산화단층혈관 촬영술을 사용한다. 치료 약제로 경구 비타민 K 길항제가 사용되었으나, 최근에는 정기적인 모니터링이 필요하지 않은 약제들이 새롭게 사용되고 있다. 저자들은 진행성 위암환자에서 발생한 하지 심부정맥 혈전증 및 폐동맥 혈색전증에 있어 저분자량 헤파린을 투여하며, 호전된 사례를 문헌고찰과 함께 보고하는 바이다.

Keywords

References

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