Acute pulmonary embolism originating from upper limb venous thrombosis following breast cancer surgery:Two case reports

BACKGROUND Upper limb venous thrombosis(ULVT)is rarer than lower-extremity deep venous thrombosis,and is related to Paget-Schroetter syndrome,central venous catheterization,and malignancy.There are few reports of pulmonary embolism(PE)from upper-extremity vein thrombosis due to surgery.Herein,we report two cases of PE that originated from upper limb venous thrombosis on the surgical side in two patients undergoing modified radical mastectomy for breast cancer.These cases challenge the traditional theory that PE originate only from the lower extremities.CASE SUMMARY We describe two female patients,aged 68 and 65 years,respectively,who had undergone modified radical mastectomy for breast cancer.They did not have a central venous catheter and did not undergo preoperative neoadjuvant chemotherapy.They were transferred to the intensive care unit due to symptomatic PE on the first day after surgery.Colour Doppler ultrasound identified fresh thrombosis in their upper limb veins,which was the presumed source of the PE.They all received anticoagulation therapy,and one of them experienced bleeding that required discontinuation of the drug.Ultimately,they were discharged in stable condition.CONCLUSION ULVT as a source of PE after breast cancer surgery cannot be ignored.

Prevention and Treatment of Deep Vein Thrombosis of the Lower Limbs in Patients with Complications after Orthopedic Trauma Surgery

Objective:To explore and analyze on how to prevent and treat deep vein thrombosis of the lower limbs in patients with complications after orthopedic trauma surgery.Methods:The research patients were selected from the cases of surgical treatment of orthopedic trauma in the hospital during the past two years,and a total of 58 patients were selected.The patients were randomly divided into two groups,with 29 patients in the control group treated with conventional clinical methods;and the other 29 patients were assigned to the experimental group,where targeted preventive and therapeutic measures were administered.During the research,the number of complications of postoperative deep vein thrombosis of the lower limbs and the corresponding treatment efficacy were compared between the two groups of patients.Results:According to the results of clinical experiments,the probability of patients in the experimental group suffering from deep vein thrombosis of the lower limbs after surgery was significantly lower than that of the control group(P<0.05);in addition,when complications of deep venous thrombosis of the lower limbs occurred,the treatment efficacy of the patients in the experimental group was 96.55%,and the treatment efficacy of the patients in the control group was 82.76%.There was a significant difference between the two groups(P<0.05).Conclusion:Through clinical experiments to study and analyze the prevention and treatment measures of deep vein thrombosis in patients with complications after orthopedic trauma surgery,this research proves that active and comprehensive preventive and treatment measures can effectively reduce the number of complications and improve surgery treatment efficacy.