Abstract
Pulmonary Embolism (PE) is one of the most dangerous complications in orthopaedic and accident surgery. Here we report on two cases of successful management of PE after orthopaedic surgery.
The case 1 of 46-year-old woman with L4 degenerative spondylisthesis, she received an anterior interbody fusion in September, 1988. At 30 days after surgery, she complained of acute chest pain and went into shock. Based on X-ray findings, ECG readings, heart echo and some laboratory evaluation, PE was highly suspected. Anticoagulant therapy (heparin) and thrombolysis therapy (urokinase) were immediately started in the ICU.
The case 2 of 58-year-old woman with left hip osteoarthritis, she received the THA in August, 1998. She complained of dyspnea and went into shock 15 days after surgery. Heart echo, chest CT, and pulmonary arteriography clearly indicated PE, and immediate anticoagulant and thorombolysis therapy was started in the ICU. Fortunately, both cases had successful results.
Fatality rate of PE is very high, and PE after surgery has been increasing in Japan. Several reports detail the risk factors associated with this lesion. Therefore, orthopaedic surgeons should take care of this disease, especially on risk factors and early diagnosis.
