A Case of Protein-Losing Gastroenteropathy due to Constrictive Pericarditis after Cardiac Surgery
- VernacularTitle:蛋白漏出性胃腸症を呈した開心術後収縮性心膜炎の1手術例
- Author:
Osamu NAMURA
1
;
Takeshi OKAMOTO
1
;
Norihito NAKAMURA
1
;
Shinya MIMURA
1
;
Takuma MURAOKA
1
;
Ryohei KOBAYASHI
1
;
Masanori TSUCHIDA
1
Author Information
- Keywords: protein-losing gastroenteropathy; constrictive pericarditis after cardiac surgery; pericardiectomy
- From:Japanese Journal of Cardiovascular Surgery 2020;49(4):222-227
- CountryJapan
- Language:Japanese
- Abstract: A 36-year-old man underwent direct closure of an atrial septal defect through median sternotomy at the age of 14. He also underwent a mitral valve replacement with tricuspid annuloplasty using the same approach at the age of 18. The patient also presented with pretibial edema and congestive liver disease at the age of 27 and the pretibial edema progressed at the age of 35. Hypoalbuminemia (TP ; 3.6 g/dl, Alb ; 1.6 g/dl) was also observed. Further examinations were performed, which revealed that the right ventricular pressure curve presented a dip and plateau pattern by cardiac catheterization. Computed tomography of the chest additionally revealed thickened and calcified pericardium in the left ventricle. Abdominal scintigraphy showed tracer accumulation in the transverse colon hepatic flexure 4 h after intravenous administration of technetium-99m-labelled human serum albumin. The patient was diagnosed with a protein-losing gastroenteropathy caused by constrictive pericarditis. He underwent pericardiectomy via left anterior thoracotomy without cardiopulmonary bypass. No complications were present after the surgery, and he was discharged after 46 postoperative days. Following his discharge from the hospital, the pretibial edema disappeared, and serum albumin levels gradually increased and normalized within 3 months after the surgery (TP 7.1 g/dl, Alb 4.2 g/dl).
