Abstract
We encountered a case of pulmonary thromboembolism after left pnemonectomy for lung cancer. The patient was saved by urgent treatment with transvenous catheter pulmonary embolectomy and thrombolytic agents. Whole body CT revealed a left internal jugular vein thrombus, which was considered to be the cause of the pulmonary thromboembolism. The left internal jugular vein thrombus was possibly formed during the operation, since blood stasis induced by holding the innominate vein with tape for a long time could allow thrombus formation. Therefore, we must give special attention to such intraoperative manipulation. In this case, the hypercapnea was recognized, instead of the hypocapnea that is usually shown in pulmonary thromboembolism. The reason the hypercapnea was presented was considered to be that the gas-exchangeable pulmonary vessel was decreased excessively due to pulmonary thromboembolism. It is important that the hypercapnea may be evident in cases of pulmonary thromboembolism after pulmonary resection, whereas the hypocapnea is shown in usual pulmonary thromboembolism.
