Diagnosis and Treatment of Massive Pulmonary Thromboembolism in a Patient with Metastatic Colon Adenocarcinoma

Year 2013, Volume: 5 Issue: 2, 22 - 28, 01.12.2013

Süreyya Yılmaz Yaşar Yıldırım Zülfükar Yılmaz Emre Aydın Recai Akdoğan Barış Çil Ali Kemal Kadiroğlu Füsun Topçu M. Emin Yılmaz

Abstract

Aim: Massive pulmonary thromboembolism (PTE) is one of the cause of unexpected deaths in
hospitalized patients. Our aim is to present diagnosis and treatment of massive pulmonary
thromboembolism in a patient with pneumonia and cancer.
Case: A 52 years old male with a metastatic colon adenocarcinoma, admitted to the emergency
department with shortness of breath, one month after the right hemicolectomy and chemotherapy.
The physical examination of the patient: general condition was bad and he had tachypnea,
tachycardia, and rals in the left lung bases and leukocyte: 21.000 K/ml, CRP: 28mg/dl, Ph:7.46,
PaO2:56.6, PaCO2:23.2, SO2:%82, HCO3:19.8. Tachypnea, tachycardia, hypoxia, hypocapnia,
and respiratory alkalosis was observed, PTE was considered and diagnosed by CT pulmonary
angiography. 50 mg Alteplase was applied to the patient. After administration of alteplase, general
condition was improved (pH:7.37, PaO2:85.1, PaCO2: 38.9,SO2:98.5%, HCO3:20.3).
Conclusion:Pneumonia, may mask the diagnosis of PTE and should be considered in patients with
dyspnea, hypocapnia, hypoxia, and hypotension

Keywords

Colonic Neoplasms, Pneumonia, Pulmonary Embolism, Thrombolytic Therapy

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