Two Cases of Acute Pulmonary Embolism after Esophageal Cancer Operation

Takashi Kanazawa,Nobuyuki Watanabe,Yoshio Naomoto,Masahiko Kobayashi, Yasuhiro Shirakawa,Tomoki Yamatsuji,Naoya Kobayashi,Toshiyoshi Fujiwara, Nagahide Matsubara,Hiromi Iwagaki,Junji Matsuoka and Noriaki Tanaka Department of Gastroentelogical surgery,Okayama University Graduate School of Medicine, Dentistry and Phamaceutical Sciences,Okayama 700-8558,Japan We encountered two cases of pulmonary embolism(PE)/venous thrombs(DVT)after surgery for esophageal cancer.The first case was a 58-year-old male.He underwent a subtotal esophagectomy and reconstruction using the stomach via the subcutaneus route.His postoperative course was stable;however,13 days after the operation,he had an elevated fever and pulmonary thrombi were observed on CT-scan screening.Scintigraphy confirmed the thrombi. An inferior vena cava filter(IVCF)was inserted and anti-coagulation therapy using heparin was started.His fever subsided,and 35 days after the operation,the thrombi disappeared.He was discharged thereafter and is being followed up using warfarin.The second case was a 74-year-old male.He also underwent subtotal esophagectomy and reconstruction using the stomach via the subcutaneus route.A central line was inserted via right femoral vein; however,the artery was injured and pressurization to the vessel was needed.His post-operative course was stable and symptom-free;however,ultrasound screening detected DVT in his right femoral vein.IVCF was mserted and anti-coagulation therapy was begun,thrombi disappeared 8 days after the therapy.