Considerations of Pulmonary Thromboembolism and Anesthesia / 대한마취과학회지

ABSTRACT

BACKGROUND: Pulmonary embolism can occur in various clinical situation and its diagnosis is difficult to be made but once it happens it can be a fatal disease to cause a death. We investigated 27 autopsied cases in the recent three years at National Institute of Scientific Investigation (NISI) who received anesthesia and diagnosed as pulmonary thromboembolism as cause of death and evaluated clinial situation and mortality by reviewing medical records. METHODS: Among 6848 autopsied cases in NISI from 1/1997 to 12/1999, 27 cases who were recieved anesthesia and whose cause of death were confirmed as pulmonary thromboembolism were investigated through its autopsy record, clinical record and statement. RESULTS: The type of anesthesia of 17 cases was general anesthesia, 4 cases was local anesthesia and 6 cases was unknown. As clinical distribution, obstetric were 17 cases, orthopedic 7 cases and thoracic surgery, general surgery and urology were 1 cases. By comparing the time interval between operation and death, 7 cases of obstetric were on postoperative 1 2 days. Deep thromboembolism was observed on lower extremities by 22 cases and anatomocally heart lesion was observed by 14 cases by autopsy. CONCLUSIONS: Pulmonary thromboembolism is one of the leading causes of sudden postoperative death, but because reliable symptoms, signs and diagnostic methods were absent, physician have to be aware of the problem and make effort to diagnose if possible.