Systemic Thrombolytic Therapy for Pulmonary Embolism in Early Postoperative Period Following Laparoscopic Vaginal Hysterectomy
Published: January 1, 2019 | DOI: https://doi.org/10.7860/JCDR/2019/39660.12454
BV Sunil, Shaik Gulam Osmani, S Neeta, Sarath Venugopal, Hariharan Kannan
1. Associate Professor, Department of Anaesthesia, Kasturba Medical College, Mangalore, Karnataka, India.
2. Assistant Professor, Department of Anaesthesia, Kasturba Medical College, Mangalore, Karnataka, India.
3. Associate Professor, Department of Anaesthesia, Kasturba Medical College, Mangalore, Karnataka, India.
4. Postgraduate Student, Department of Anaesthesia, Kasturba Medical College, Mangalore, Karnataka, India.
5. Postgraduate Student, Department of Anaesthesia, Kasturba Medical College, Mangalore, Karnataka, India.
Correspondence
Dr. Shaik Gulam Osmani,
C1-8, Kasturba Medical College Quarters, Near Jyothi Circle, Mangalore-575001, Karnataka, India.
E-mail: dr.sg.osmani@gmail.com
A 51-year-old female underwent a laparoscopic-assisted vaginal hysterectomy for fibroid uterus. After an uneventful procedure, the patient developed symptoms of Pulmonary Thromboembolism (PTE). The PTE was managed with, systemic thrombolysis using tissue plasminogen activator (Tenecteplase), appropriate support of inotropes and anticoagulants. While there is less incidence of PTE in laparoscopic procedures, in particular, in gynaecology, there is a definite risk even in a patient with low-risk factors, which has been highlighted. Prompt diagnosis, aggressive therapy and adequate haemodynamic support go a long way to reduce mortality and morbidity from this life-threatening complication.
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