泌尿器科手術に合併した肺塞栓症の3例

Three cases of pulmonary embolism associated with urological surgery

　泌尿器科手術に合併した3例の肺塞栓症を経験したので報告した。2例はhigh risk症例であり，積極的な予防策が必要と考えられた。1例は深部静脈血栓症が原因として考えられたが，術前に予測は困難であった。周術期肺塞栓症は致命的な合併症であり，いかなる症例にも発症しうるということを認識し，その予防と早期診断が重要と考えられた。

We report three cases of pulmonary embolism occurred after major urologic surgery. Two cases had such risk factors as obstruction of an arteriovenous fistula con-structed as A-V shunt for hemodialysis at the wrist, and subsequent indwelling of a central venous catheter as blood access in one case, and caval involvement of renal cell carcinoma in the second case. The third case had no medical history or complication which caused increased coagulability or decreased fibrolytic activity. Pulmonary embolism should always be taken into consideration as a fatal complication of surgery.