• Title/Summary/Keyword: 폐혈전색전증

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Primary Pulmonary Artery Osteosarcoma Mimicking Acute Pulmonary Artery Embolism - A case report- (급성 폐동맥 색전증으로 의심된 원발성 폐동맥 골육종 -1예 보고-)

  • 박상현;손정환;지현근;신윤철;유병수;박우정;박혜림;김응중
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.929-932
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    • 2004
  • The estimated relative incidence of primary pulmonary sarcoma to lung cancer is 0.4%. Furthermore, osteogenic sarcoma of the pulmonary artery is extremely rare. We report a case of a 63-year-old woman who visited our emergency room with the chief complaints of chest pain, dyspnea and dizziness. On echocardiography, right heart failure due to acute pulmonary artery embolism was diagnosed and we performed emergency operation. After opening the main pulmonary artery trunk, we found a mass attached to the arterial wall and massive thrombi around the mass. The mass was diagnosed as primary pulmonary artery osteosarcoma through postoperative evaluation. The patient received chemotherapy and radiotherapy. The patient is alive without specific symptoms 16 months postoperatively.

Comparison of Effect Between Thrombolysis and Anticoagulation in Major Pulmonary Thromboembolism (쇽 혹은 우심실부전을 보이는 중증 폐혈전색전증에서 혈전용해요법과 항응고요법의 효과)

  • Han, Song Yi;Song, Jae Kwan;Lee, Sang Do;Lim, Chae-Man;Koh, Younsuck;Park, Chan Sun;Oh, Yeon Mok;Shim, Tae Sun;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.487-496
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    • 2005
  • Background : 'Major pulmonary thromboembolism' is defined as right ventricular (RV) dysfunction, with or without shock, accompanied by significant morbidity and mortality. In this study, those with major pulmonary thromboembolism were divided into the shock and RV dysfunction only groups, and then investigated the mortality and complications in thrombolysis or anticoagulation, respectively. Methods : In a retrospective study, between January 1995 and December 2004, 60 eligible patients with a major pulmonary thromboembolism, admitted in Asan Medical Center, were included. Results : A total of 57 patients were treated with medical therapy. Thrombolysis was performed in 13 patients (23%) and anticoagulation in 44 (77%). There were no differences in the APACHEII and SOFA scores between the two groups. 6 (46%) and 11 (25%) patients died in the thrombolysis and anticoagulation groups, respectively (p=0.176). In the 19 patients (33%) showing shock, thrombolysis was performed in 9 (47%) and anticoagulation in 10 (53%). 4 (44%) of the 9 patients treated with thrombolytic agents and 3 (30%) of the 10 treated with anticoagulants died (p=0.650). In the 38 patients (67%) showing RV dysfunction only, thrombolysis was performed in 4 (11%) and anticoagulation in 34 (89%). 2 (50%) of the 4 patients treated with thrombolytics and 8 (24%) of the 34 treated with anticoagulants died (p=0.279). Three patients (23%) who underwent thrombolysis had a major bleeding episode, compared with 2 (5%) who were treated with anticoagulants (p=0.072). Conclusion: The results of our study showed that thrombolysis did not lower mortality and tended to increase major bleeding compared with anticoagulation in both the shock and RV dysfunction only groups. Further evaluation of the efficacy and safety of thrombolytic therapy for major thromboembolism appears warranted in Korea.

Pulmonary Thromboembolism after Intravenous Immunoglobulin Therapy in Guillain-Barre Syndrome (길랭-바레증후군에서 면역글로불린 치료 후 발생한 폐혈전색전증)

  • Park, Jin-Mo;Kim, Nam Kyun;Park, Jin-Sung
    • Annals of Clinical Neurophysiology
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    • v.18 no.1
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    • pp.14-17
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    • 2016
  • Intravenous immunoglobulin (IVIG) is a safe treatment to treat various neurological disorders, but fatal thrombotic events as rare complications have been reported. A 54-year-old woman with Guillain-Barre syndrome complained of dyspnea during IVIG treatment. She was finally diagnosed with pulmonary thromboembolism. To the best of our knowledge, this is the first case of pulmonary thromboembolism associated with IVIG treatment in a Korean patient with Guillain-Barre syndrome.

A Case of Acute Lung Injury Complicated by Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma (간세포암의 간동맥 화학색전술 후 발생한 급성 폐손상 1예)

  • Cho, Se-Haeng;Kim, Joo-Hang;Kim, Byung-Soo;Jang, Joon
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.5
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    • pp.781-786
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    • 1995
  • Transcatheter arterial chemoembolization(TACE) was performed in a 61 year old male patient with hepatocellular carcinoma with 10 cc of Lipiodol and 50 mg of doxorubicin. Three days later, he complained of dyspnea and dry cough. The arterial blood gas study revealed moderate hypoxemia and hypocarbia. The chest PA showed acute pulmonary edema with bilateral pleural effusion. To rule out the possibilities of acute respiratory failure caused by infection, pulmonary embolism or congestive heart failure, we performed several laboratory studies. The blood and sputum culture studies revealed negative results for bacterial growth. The echocardiogram was normal. The abdominal CT scan and MR imaging revealed no thrombus or mass lesion in the inferior vena cava. So we concluded pulmonary oil embolism induced by lipiodol as the cause of acute lung injury. Four weeks later, clinical symptoms and chest x-ray were markedly improved with conservative care. We report a case of acute lung injury after TACE with lipiodol and doxorubicin, with review of literatures.

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The Effects of the Bojungikgi-tang added Magnoliae Flos on the Pulmonary Thromboembolism and Delayed Allergy Response (보중익기탕(補中益氣湯) 가(加) 신이(辛夷)가 폐혈전색전(肺血栓寒栓) 및 지연형(遲延型) allergy반응(反應)에 미치는 영향(影響))

  • Kang, Yoon-Kyung;Park, Dong-Il;Kang, Pil-Koo
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.487-493
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    • 2000
  • Objective : This experimental studies were done to research the effects of Bojungikgi-tang added Magnoliae Flos on the pulmonary thromboembolism and delayed allergy response. Methods : Healthy rats were devided into each group. This test is to inject sodium arachidonic acid to one group, and ADP(adenocine diphophate) to the other one afterward to compare the survival rate between each other. Delayed allergy response test is to inject PC(picryl chloride) to one group and measure the thickness of their ears, to inject SRBC(sheep red blood cell) allergen to the other, and measure their foot edema, and compare the each other rates Results : The extract of the Bojungikgi-tang added Magnoliae Flos revealed significant effect on the pulmonary thromboembolism induced by sodium arachidonate, or adenocine diphophate(ADP). And the extract of the Bojungikgi-tang added Magnoliae Flos revealed significant effect on delayed type hypersensitivity induced by picryl chloride(PC), or sheep red blood cell(SRBC). Conclusions : According to the above findings it is suggested that the extract of the Bojungikgi-tang added Magnoliae Flos revealed significant effect on the delayed type hypersensitivity and effect on the pulmonary thromboembolism.

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Clinical Study of the Patients, in Whom Pulmonary Embolism was Suspected by Lung Perfusion Scan (폐 관류주사검사상 폐동맥 색전증 소견을 보인 환자의 임상적 고찰)

  • Lee, Gwi-Lae;Kim, Jae-Yeol;Park, Jae-Suk;Yoo, Chul-Gyu;Kim, Young-Whan;Shim, Young-Soo;Han, Sung-Koo
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.4
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    • pp.889-898
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    • 1997
  • Pulmonary Embolism can develop in variable conditions, and presents with nonspecific symptoms and signs. If diagnosis is delayed, it can be resulted in catastrophic results. Therefore, early diagnosis and adequate treatment is crucial in Pulmonary Embolism. Lung Perfusion Scan is useful screening test. Negative result can exclude pulmonary embolism. But, perfusion defects don't always mean pulmonary embolism. To find the better methods of interpretation of lung perfusion scan and To evaluate the clinical course and outcomes of the patients, in whom pulmonary embolism was suspected by lung perfusion scan, we reviewed the clinical records of 49 cases suspected by lung perfusion scan at Seoul National University Hospital during the period of January, 1995 to July, 1996. The results are as follows. First impression of cases in which PE was present at time of admission were pulmonary embolism (63%), heart diseases (26%), and pneumonia (11%) in orders. Underlying diseases of cases in which PE developed during admission were malignancy (36.5%), ICH (22.7%), sepsis (13.7%), and SLE (9.1%) in orders. The predisposing factors were operation (20%), cancer (16%), immobility (16%), connective tissue disease (16%), heart dis. (10%), old age (10%), and preg/pelvic dis. (8%) The results, of lung perfusion scan were HPPE 40 cases(26.8 %), IPPE 21 cases(14.1%), LPPE 88 cases (59.1%), and cases(%) of treatment in these cases were HPPE 34 cases(85%), IPPE 9 cases(42.9%), LPPE 0 case(0.0%). Treatments were heparin and warfarin (69.5%), heparin alone (8.2%), warfarin alone (2.0%), embolectomy (4.1%), thrombolytics (2.0%), IVC filter (2.0%), and no treatment (12.2%) In 34 cases (69.4%), follow up could be done, and 5 cases were recurred (10.2%). The causes of recurrence was incomplete anticoagulant therapy (3 cases) and recurrence of predisposing factor (2 cases). Expired case due to pulmonary embolism was one who was expired just before trial of thrombolytic therapy. Conclusion : Efforts should be made to shorten the interval from onset of Sx to Dx, ie, high index of suspision.

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Surgical Treatment of Pulmonary Artery Sarcoma -One case report- (급성 폐동맥 색전증으로 오인된 폐동맥 육종 -1예 보고-)

  • Park, Kuhn;Kwon, Jong-Bum;Lee, Jong-Ho;Kang, Jae-Kul;Kim, Hwan-Ook;Jo, Keon-Hyon;Wang, Young-Pil
    • Journal of Chest Surgery
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    • v.37 no.7
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    • pp.597-600
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    • 2004
  • We report a rare case of pulmonary artery sarcoma mimicking pulmonary artery thromboembolism in a 57-year-old man who suffered with 2-month dyspnea and exacerbated for 1 week. He was transferred from private clinic and he was diagnosed as acute pulmonary artery thromboembolism on the basis of chest CT. Chest CT, pulmonary artery angiogram, and perfusion scan were examined. We performed surgical excision with aid of CPB. The final pathologic report was that the mass was a pulmonary artery sarcoma. We experienced one case of pulmonary artery sarcoma and reported it with reference.

Pulmonary Thromboendarterectomy Under Total Circulatory Arrest (완전순환정지를 이용한 폐동맥색전증의 수술 치험 1례)

  • Kim, Chang-Young;Kang, Chang-Hyeun;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.35 no.9
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    • pp.684-687
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    • 2002
  • Besides lung transplantation, pulmonary thromboembolectomy is the only effective therapeutic option for chronic thromboembolic pulmonary hypertension. It is however associated with a considerably high hospital mortality between 6.6 to 23%. Proper patient selection is critical when considering a patient for pulmonary thromboembolectomy. And It cannot be overemphasised that the key to the success of the operation is complete endarterectomy of the entire pulmonary arterial tree. We report that pulmonary thromboendarterectomy under total circulatory arrest was an effective and safe method in the surgical correction of the chronic thrornboernbolic pulmonary hypertension and enabled complete removal of superimposed peripheral organized thrombi in a good operative field.

Pulmonary Thromboembolism Presenting with Upper Thoracic Back Pain -A case report- (좌측 상 배부 통증으로 발현된 폐혈전색전증의 증례 -증례 보고-)

  • Lee, Ji Young;Choi, Jin Hwan;Choi, Chang Hoon
    • The Korean Journal of Pain
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    • v.19 no.1
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    • pp.119-122
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    • 2006
  • Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.

Diabetic ketoacidosis with pulmonary thromboembolism (당뇨병성 케톤산증에서 발생한 폐혈전색전증)

  • Kim, Dong Min;Lee, Jeonghun;Nam, Soo Min;Lee, Yeon Sun;Moon, Hee;Lee, Kang-Woo;Jang, In Wook
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.99-102
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    • 2014
  • Diabetic ketoacidosis (DKA), a fatal acute diabetic complication, is characterized by severe metabolic decompensation and intravascular volume depletion. These conditions may result in hypercoagulability and prothrombic state. Pulmonary thromboembolism (PTE) could be presented as an uncommon and life-threatening complication of DKA. Reported herein is a case involving a 54-year-old male patient who was admitted with DKA due to chronic alcohol consumption and stopping the intake of oral antidiabetic drugs. After low-molecular-weight heparin and warfarin treatment because of PTE during the DKA treatment, the patient's condition improved over the week that he was discharged on insulin and warfarin.