Abstract
An 81-year-old man visited our outpatient department with a chief complaint of lower abdominal pain. Detailed diagnostic examination revealed circumferential sigmoid colon cancer. The patient had a history of deep venous thrombosis of the left leg and had been diagnosed with congenital antithrombin III (AT III) deficiency ; he was under anticoagulant treatment with warfarin. Magnetic resonance venography (MRV) of the legs showed a residual thrombus in the left common iliac vein, and the patient was considered to be at a high risk of developing perioperative thromboembolism. During the perioperative period, heparin and AT III concentrate were used to control the activated partial thromboplastin time. Moreover, an inferior vena cava (IVC) filter was placed to prevent pulmonary embolism. The operation was completed without any problem. Following a satisfactory postoperative course, the patient was discharged on the 22nd day after surgery. Congenital AT III deficiency is a rare disease, and thromboembolism can be induced by surgery, trauma, pregnancy, childbearing, etc. Even when surgery is required and the presence of preoperative deep venous thrombosis is confirmed, as in this case, perioperative use of heparin, AT III concentrate, and an IVC filter can prevent fatal pulmonary embolism and allow surgery to be performed.
