Asymptomatic Deep Venous Thrombosis and Pulmonary Embolism Diagnosed before Pancreas Cancer Operation-Report of a Case

Abstract

We report a 68-year-old man preoperatively diagnosed with a pulmonary embolism (PE) and deep venous thrombosis (DVT) who underwent successful pancreatic cancer surgery. He underwent pulmonary perfusion scintigraphy and computed tomography (CT) preoperatively. Lung scintigraphy showed multiple defects in both lung lobes, and CT showed DVT of the left peroneal vein. Anticoagulant therapy was initiated immediately after the diagnosis and stopped during surgery. Pancreaticoduodenectomy was done with a physical modality alone to prevent DVT, and anticoagulant therapy was restarted the next day. The patient recovered uneventfully and pulmonary scintigraphy taken on postoperative day 8 showed improved bilobular defects. This case demonstrates the possibility that patients with preexisting asymptomatic PE may be diagnosed postoperatively with PE after the manifestation of clinical symptoms.