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Prediction of Pulmonary Embolism Following Resection of Pulmonary Infarction : A Case Series

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Title: Prediction of Pulmonary Embolism Following Resection of Pulmonary Infarction : A Case Series
Authors: Yamasaki, Hiroshi Browse this author
Ujiie, Hideki Browse this author
Kato, Tatsuya Browse this author
Hida, Yasuhiro Browse this author →KAKEN DB
Kaga, Kichizo Browse this author →KAKEN DB
Wakasa, Satoru Browse this author →KAKEN DB
Matsuno, Yoshihiro Browse this author →KAKEN DB
Keywords: pulmonary infarction
pulmonary embolism
deep venous thrombosis
venous thromboembolism
Issue Date: 2021
Publisher: The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery
Journal Title: Annals of Thoracic and Cardiovascular Surgery
Volume: 27
Issue: 6
Start Page: 371
End Page: 379
Publisher DOI: 10.5761/atcs.oa.20-00396
Abstract: Purpose: Pulmonary nodules suspected to be cancerous are rarely diagnosed as pulmonary infarction (PI). This study examined the clinical, radiological, and laboratory data in cases diagnosed with PI to determine their potential utility as preoperative diagnostic markers. We also assessed factors affecting the postoperative course. Methods: A total of 603 cases of peripheral pulmonary nodules undiagnosed preoperatively were resected at Hokkaido University Hospital from 2012 to 2019. Of these, we reviewed cases with a postoperative diagnosis of PI. We investigated clinical symptoms, preoperative laboratory data, radiological characteristics, and postoperative complications. Results: Four patients (0.7%) were diagnosed with PI. All patients had a smoking history. One patient received systemic steroid administration, and none had predisposing factors for thrombosis. One case showed chronologically increased nodule size. Three cases showed weak uptake of 18F-fluorodeoxyglucose. One patient with preoperative high D-dimer levels developed a massive pulmonary embolism (PE) in the postoperative chronic phase and was treated with anticoagulants. Conclusions: Preoperative diagnosis of PI is difficult, and we could not exclude lung cancer. However, if a patient diagnosed with PI has a high D-dimer level, we recommend postoperative physical examination for deep venous thrombosis. Prophylactic anticoagulation therapy should be considered to avoid fatal PE.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 氏家 秀樹

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