Adult ; Humans ; Male ; Palate ; surgery ; Postoperative Complications ; Pulmonary Embolism ; etiology ; Snoring ; surgery ; Uvula ; surgery

Pulmonary fat embolism (PFE) and pulmonary thromboembolism (PTE) are common post-operative complications of orthopedic surgical procedures, but are reported less often following maxillofacial plastic surgical procedures, especially with respect to PFE. Thrombi, or together with fat emboli in pulmonary vessels can induce hemorrhagic infarction and cause death. Herein this report introduced a death due to pulmonary hemorrhagic infarction following maxillofacial plastic surgery. The female patient underwent several osteotomies of the mandible, zygomas and autologous bone grafting within a single operation. The operative time was longer than normal and no preventive strategies for pulmonary embolism were implemented. The patient died 20 days after hospital discharge. The autopsy confirmed pulmonary hemorrhagic infarction. The fat emboli and thrombi were also noted in the pulmonary vessels, which were thought to have resulted from the maxillofacial osteotomy. Suggestions were offered to forensic pathologists that risk factors of PFE and PTE, such as the type and length of surgery, the surgical sites, and the preventive strategies, should be considered when handling deaths after maxillofacial operations.
Adult ; Autopsy ; Cause of Death ; Embolism, Fat/complications* ; Fatal Outcome ; Female ; Forensic Pathology ; Humans ; Infarction/etiology* ; Maxillary Osteotomy ; Postoperative Complications ; Pulmonary Embolism/complications* ; Surgery, Plastic/adverse effects* ; Thromboembolism/complications*

A male patient with hypopharyngeal cancer accepted operation under general anesthesia. Sixth day after surgery in patient with sudden chest pain and obvious difficulty in breathing. Blood oxygen saturation of 90%. The electrocardiogram showed: ST-T change,Tv6 flat;blood gas analysis: pH 7. 491, PCO2 34. 1 mmHg, PO2 54. 7 mmHg; D-Dimer 3. 87 mg/L; white blood cell 17. 50 × 10(9)/L. CTPA showed: right pulmonary artery embolism,pulmonary infection. Another male patient with the right tonsil cancer accepted operation under general anesthesia. Fourth day of patient suddenly appear bosom frowsty and obvious difficulty in breathing. Blood oxygen sat- uration of 88%. Blood gas analysis: pH: 7. 48, PCO2 : 33 mmHg, PO2 : 57 mmHg; D-Dimer: 2. 97 mg/L; white blood cell:11. 80 × 10(9)/L. CTPA showed: the main pulmonary artery and right pulmonary artery branch embolism, pulmonary inflammation. Both were diagnosised as acute pulmonary embolism and recovered well after giving anticoagulant therapy in time.
Anesthesia, General ; Electrocardiography ; Fibrin Fibrinogen Degradation Products ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Laryngeal Neoplasms ; surgery ; Male ; Oxygen ; Postoperative Complications ; Pulmonary Embolism

A 51-yr-old man presented exertional dyspnea as a consequence of iliocaval fistula combined with paradoxical pulmonary embolism and high-output heart failure. Endovascular stent-graft repair was performed to cover iliocaval fistula and restore the heart function. After the procedure, dyspnea was improved and procedure related complication was not seen. A 6-month follow-up computed tomography showed regression of pulmonary thromboembolism and well-positioned stent-graft without graft migration, aortacaval communication or endoleak. Stent graft implantation should be considered an alternative of open repair surgery for treament of abdominal arteriovenous fisula, especially in patient with high risk for surgery.
Dyspnea/diagnosis ; Endovascular Procedures ; Fistula/complications/*diagnosis ; Heart Failure/complications/*diagnosis/surgery ; Humans ; Iliac Vein ; Male ; Middle Aged ; Pulmonary Embolism/complications/*diagnosis/surgery ; *Stents ; Tomography, X-Ray Computed

Laparoscopy is a surgical procedure used both for diagnosis and for various treatments. A rare but sometimes fatal complication of laparoscopy is pulmonary embolism with CO2 resulting in pulmonary edema. During laparoscopic gynecological surgery in a 29-year-old woman who had previously undergone lower abdominal surgery, the end-tidal CO2 suddenly increased from 40mmHg to 85mmHg and then decreased to 13mmHg with hemodynamic deterioration. These events are characteristic of a CO2 embolism. When this occurred, CO2 insufflation was immediately stopped and the patient was resuscitated. The patient's condition gradually improved with aggressive treatment, but the clinical course was complicated by bilateral pulmonary edema. This case of pulmonary edema was soon resolved with supportive management. The formation of a CO2 embolism during laparoscopy must be suspected whenever there is a sudden change in the end-tidal CO2. In addition, the possibility of pulmonary edema should be considered when a CO2 embolism occurs.
Adult ; Carbon Dioxide/*metabolism ; *Cystectomy ; Female ; Humans ; *Laparoscopy ; Ovarian Cysts/*surgery ; Pulmonary Edema/*complications/metabolism/radiography ; Pulmonary Embolism/*complications/metabolism/radiography

BACKGROUNDColorectal surgery was regarded as one of the high risk surgery for post-operative deep vein thrombosis (DVT) and pulmonary embolism. This study aimed at investigating the incidence of venous thromboembolism (VTE) after colorectal surgery for malignancy.

METHODSData were collected from the prospective database of colorectal malignancy from 2000 to 2008. A total of 1421 colorectal (open and laparoscopic) operations were performed for the colorectal malignancy without DVT prophylaxis.

RESULTSOnly seven patients (0.5%) developed symptomatic DVT and one of them had complication of pulmonary embolism without mortality. Open operation for colorectal malignancy was identified as possible risk factor of DVT, however, risk factors like operative time, low anterior resection, sex, age etc. were not identified.

CONCLUSIONRisk of venous thromboembolism after colorectal operation is low in Chinese of our locality and it might be safe to perform colorectal operation for malignancy without DVT prophylaxis.

Aged ; Aged, 80 and over ; Colorectal Neoplasms ; surgery ; Colorectal Surgery ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; Pulmonary Embolism ; etiology ; Venous Thrombosis ; etiology

BACKGROUND: Pulmonary thrombosis embolism (PTE) is one of the most severe complications of perioperative radical mastectomy. Massive PTE is often accompanied by shock and hypotension which is characterized by rapid progression and high mortality. There is no standard for the treatment of these patients, which is thoracic surgery, and it is a critical issue in the thoracic surgeons. This article summarizes and analyzes the treatment of two patients with high-risk PTE at the early stage of postoperative lung cancer in our hospital. In addition, we discusses the diagnosis and treatment strategies of these cases to provide a reference for the thoracic surgeons. METHODS: We presented two patients with high-risk PTE at the early stage after thoracic surgery for radical surgery in our hospital back in 2017. One case was treated with intravenous venous interventional thrombolysis, and the other was treated with thrombolysis alone. The treatment effect of two patients and the complications during the treatment has been recorded to detail and summarized. RESULTS: Both patients were female who aged 66 and 61 years old. The time point of pulmonary embolism was 48 h and 45 h after operation, and the time of interventional thrombolysis was 70 minutes and 50 minutes after onset respectively. After 120 minutes and 100 minutes, the drainage after interventional thrombolysis was 4,690 mL and 520 mL respectively. The hospitalization time after thrombolysis was 21 days and 14 days respectively. There was no obvious complication through a follow-up of 6 months. CONCLUSIONS Early postoperative acute massive pulmonary embolism in lung cancer should be treated with pulmonary interventional thrombolysis as soon as possible. Compared with intravenous thrombolysis, pulmonary interventional thrombolysis shows accuracy, easy controlling of dosage, fast curative effect and low bleeding risk.
Female ; Humans ; Lung Neoplasms ; surgery ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Pulmonary Embolism ; etiology ; therapy ; Retrospective Studies ; Thoracic Surgery, Video-Assisted ; adverse effects ; Thrombolytic Therapy

BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty* ; Cicatrix, Hypertrophic ; Cosmetic Techniques ; Humans ; Lipectomy ; Medical Subject Headings ; Necrosis ; Observer Variation ; Postoperative Complications ; Pulmonary Embolism ; Reconstructive Surgical Procedures ; Seroma ; Skin ; Surgery, Plastic ; Sutures ; Venous Thrombosis

BACKGROUND: Abdominoplasty, with or without liposuction, is among the most frequently performed aesthetic procedures. Its main objective is to improve the body contour by means of excising redundant skin and fat tissue. Although abdominoplasty is considered a safe procedure with high satisfaction rates, intraoperative and postoperative complications can become a challenge for the surgical team. The aim of this article is to offer a synopsis of the most common complications arising after abdominoplasty, along with evidence-based guidelines about how to prevent and treat them. METHODS: A systematic MEDLINE search strategy was designed using appropriate Medical Subject Headings (MeSH) terms, and references were scanned for further relevant articles. RESULTS: According to the published case series, local complications are considerably more common than complications with systemic repercussions. Approximately 10% to 20% of patients suffer a local complication following abdominoplasty, while fewer than 1% suffer a systemic complication. Prevention and management strategies are critically discussed for complications including seroma, haematoma, infection, skin necrosis, suture extrusions, hypertrophic scars, neurological symptoms, umbilical anomalies, deep venous thrombosis and pulmonary thromboembolism, respiratory distress, and death. CONCLUSIONS: The complications of abdominoplasty vary in severity and in the impact they have on the aesthetic outcomes. Recommendations for prevention and management are based on various levels of evidence, with a risk of observer bias. However, most complications can be treated appropriately following the current standards, with satisfactory results.
Abdominoplasty* ; Cicatrix, Hypertrophic ; Cosmetic Techniques ; Humans ; Lipectomy ; Medical Subject Headings ; Necrosis ; Observer Variation ; Postoperative Complications ; Pulmonary Embolism ; Reconstructive Surgical Procedures ; Seroma ; Skin ; Surgery, Plastic ; Sutures ; Venous Thrombosis

OBJECTIVETo discuss the clinical characteristics, early diagnosis and treatment for pulmonary embolism after spine surgery.

METHODSFrom January 1995 to May 2006, 11 cases suffered pulmonary embolism after spine surgery in the total of 10 993 patients. The clinical characteristics, diagnosis and treatment of these 11 cases were retrospectively analyzed.

RESULTSThe incidence of pulmonary embolism was 0.1% after spine surgery. Pulmonary embolism was found during 5 to 14 days after spine surgery (mean 9.8 days). All of them show characteristic syndrome of pulmonary embolism, such as difficult breathe, cardiopalmus, thoracodynia, hemoptysis. Five patients died, and the mortality was 45.5%. The earlier use of pulmonary angiography and embolectomy by catheter device, the lower mortality will be. It is significantly.

CONCLUSIONSPulmonary embolism is one of the serious complications after spine surgery. It is the period of high happening on deadly PE and the mortality during 1 to 2 weeks after spine surgery. Pulmonary angiography and interventional therapy take an important part in the early diagnosis and treatment.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Prognosis ; Pulmonary Embolism ; diagnosis ; etiology ; therapy ; Retrospective Studies ; Spine ; surgery