Perioperative Management of Case of Gynecological Malignancy with Bilateral Deep Venous Thrombosis of Lower Limbs Along with Pulmonary Embolism
MK Arora, Rakesh Garg
DOI: 10.4236/ojanes.2011.11001   PDF    HTML     6,463 Downloads   10,429 Views   Citations

Abstract

We describe the anaesthetic management of 45 year female patient with pre-existing deep venous thrombosis (DVT) and pulmonary embolism (PE) who was subsequently scheduled for an laparotomy. Before planning the surgical procedures, adequate anticoagulation must be achieved to prevent further complications of DVT, thromboembolism, and pulmonary embolism in particular. The risk of stopping the anticoagulation prior to surgery must be considered and adequately discussed with the patient and surgeons. The anaesthetic plan must be selected keeping in mind the coagulation status and the need of anticoagulation in the postoperative period.

Share and Cite:

Arora, M. and Garg, R. (2011) Perioperative Management of Case of Gynecological Malignancy with Bilateral Deep Venous Thrombosis of Lower Limbs Along with Pulmonary Embolism. Open Journal of Anesthesiology, 1, 1-4. doi: 10.4236/ojanes.2011.11001.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] Anaya DA, Nathens AB. Thrombosis and coagulation: deep vein thrombosis and pulmonary embolism prophylaxis. Surg Clin N Am 2005;85:1163-77.
[2] Lyman GH, Khorana AA, Falanga A, Pearson DC, Flowers C, Jahanzeb M, Kakkar A et al. American Society of Clinical Oncology Guideline: Recommendations for Venous Thromboembolism Prophylaxis and Treatment in Patients With Cancer. J Clin Oncol 2007;25:5490-505.
[3] Levitan N, Dowlati A, Remick SC, Tahsildar HI, Sivinski LD, Beyth R, et al. Rates of initial and recurrent thromboembolic disease among patients with malignancy versus those without malignancy. Medicine, 1999;78;285-291.
[4] Blom JW, Doggen CJM, Osanto S. Malignancies, prothrombotic mutations, and the risk of venous thrombosis. JAMA 2005;293:715-22.
[5] Bates SM, Ginsberg JS. Treatment of deep-vein thrombosis. N Engl J Med. 2004;351:268-277.
[6] Martino MA, Borges E, Willianson E, Siegfried S, Cantor AB, Lancaster J, et al. Pulmonary embolsim after major abdominal surgery in gynecologic oncology. Obstet Gynecol 2006;107:666-71.
[7] Comfere TB, Sprung J, Case KA, Dye PT, Johnson JL, Hall BA, et al. Predictors of mortality following symptomatic pulmonary embolism in patients undergoing noncardiac surgery. Can J Anesth 2007;54:634-41.
[8] Rosenberger P, Shernan SK, Shekar PS, Tuli JK, Weissmuller T, Aranki SF, et al. Acute hemodynamic collapse after induction of general anesthesia for emergent pulmonary embolectomy. Anesth Analg 2006;102:1311-5.
[9] Sutin KM, Schneider C, Sandhu NS, Capan LM. Deep venous thrombosis revealed during ultrasound-guided femoral nerve block. Br J Anaesth 2005;94:247-8.
[10] Snow V, Qaseem A, Barry P,Hornbake ER, Rodnick JE, Tobolic T et al. Management of venous thromboembolism: A clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med 2007; 146: 204-210.
[11] Segal JB, Streiff MB, Hofmann LV, Thornton K, Bass EB. Management of venous thromboembolism: A systematic review for a practice guideline. Ann Intern Med 2007; 146: 211-222.
[12] Spyropoulos AC. Investigational treatments of venous thromboembolism. Expert Opin Investig Drugs 2007;16:431-40.
[13] Stein PD, Hull RD, Patel KC, et al. D-dimer for the exclusion of deep-venous thrombosis and acute pulmonary embolism: a systematic review. Ann Int Med 2004;140(8):589-602.

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.