2021 Volume 37 Issue 3 Pages 91-96
Pulmonary thromboembolism rarely occurs after surgery in children with no systemic underlying disease. There have been no reports of pulmonary thromboembolism after craniomaxillofacial surgery in Japan to date. However, we report a rare case of pulmonary thromboembolism after Le Fort III distraction osteogenesis that did not lead to sudden patient death.
The patient was a 10-year-old girl with Crouzon syndrome. Le Fort III distraction osteogenesis was performed for midface hypoplasia and obstructive sleep apnea syndrome. On the 6th postoperative day, the patient developed headaches and exhibited cyanosis while walking. Pulmonary thromboembolism was diagnosed using chest X-ray, echocardiography, and systemic enhanced computed tomography. As anticoagulant therapy, thrombolytics and cardiac catheterization were not effective in removing the thrombus；therefore, surgical thrombectomy was performed and it was removed. During this treatment for pulmonary thromboembolism, Le Fort III distraction was continued and the targeted amount of elongation was reached on the 23rd postoperative day. Pulmonary thromboembolism is a rare complication in the craniomaxillofacial region. However, if pediatric intensive care unit management or several days of bed rest is required for children, we should also include additional measures focused on the prevention of pulmonary thromboembolism.
