A Case of Pulmonary Artery Thrombosis and Portal Vein Thrombosis Developed after Laparoscopy-assisted Low Anterior Resection

Abstract

A 61-year-old man was referred to our hospital because of anal bleeding. Colonoscopy revealed a type 1 tumor at the rectum Ra. Biopsy of the tumor revealed a diagnosis of well to moderately differentiated adenocarcinoma. Laparoscopy-assisted low anterior resection was performed with the diagnosis of rectal cancer. The operating time was 4 hours and one minute, and the operative bleeding amounted to 25 ml. The postoperative course was uneventful, but abdominal pain and an increase in inflammatory reaction occurred on the sixth postoperative day. From CT findings, we diagnosed the case as pulmonary artery thrombosis due to a thrombus of the right internal iliac vein and portal vein thrombosis due to a thrombus of the inferior mesenteric vein. Apparent abnormalities in the coagulation system were absent. Anticoagulant therapy was started and symptomatic remission and shrinkage of the thrombi on imaging were gained. The patient was thus discharged from our hospital on the 24^th postoperative day.
Since clinical cases of simultaneous occurrence of pulmonary artery thrombosis and portal vein thrombosis are quite rare, we here present our case together with a review of the literature.