Two cases of organ infarction due to thrombus in pulmonary vein stump after left lung lobectomy

Asymptomatic renal infarction after left upper lobectomy: Case report

“…In contrast to previously reported laboratory data, including urinalysis and blood investigations, which showed hematuria or elevated WBC and serum LDH, CRP, or creatinine [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , our patient only showed elevated WBC and serum LDH and CRP levels without hematuria or elevated serum creatinine. Renal function was maintained because she developed only partial infarction of the right kidney.…”

“…This condition is characterized by abdominal or lumbar pain, fever, and nausea or vomiting, and studies have reported that renal infarction was accurately diagnosed at admission in only 40% of patients [11] . Table 1 summarizes cases of renal infarction after pulmonary resection reported in the literature [4] , [5] , [6] , [7] , [8] , [9] , [10] . Contrary to the clinical presentation in previously reported cases, our patient did not present with flank pain, and/or fever, vomiting, or nausea.…”

“…Nearly all patients received anticoagulation therapy, including heparin and/or warfarin, or dipyridamole; however, no standard guidelines are available with regard to the duration of anticoagulant therapy. A few studies have reported resolution of the pulmonary vein stump thrombus and recovery of renal function using sustained anticoagulant therapy [9] , [10] ; however, the role of sustained anticoagulation therapy in patients without confirmed thrombosis remains unclear. A previous study suggested that the efficacy of non-anticoagulation therapy is similar to that of anticoagulation therapy to prevent recurrent or de novo thrombosis after idiopathic renal infarction and that this approach is associated with a lower risk of bleeding [12] .…”

“…An autopsy study reported that the incidence of renal infarction was 1.4%, and clinical diagnosis was documented in only 0.014% cases [3] . Renal infarction after pulmonary resection is rare, and this complication has typically been reported after LUL [4] , [5] , [6] , [7] , [8] , [9] , [10] . This condition is characterized by flank pain, fever, and nausea, which were reported in all cases described in the literature; however, pulmonary vein stump thrombosis is rare.…”

Pulmonary vein thrombosis and cerebral infarction after video-assisted thoracic surgery of the left upper lobe: a case series

“…Optimal antithrombotic therapy and preventive approaches for PVT remains unestablished, it should be noted that early recognition of PVT and anticoagulant therapy is important to prevent massive cerebral embolism [ 12 ]. The induction time and the duration of anti-coagulation therapy are difficult to determine because PVT can occur even after the next day of discontinuation of anticoagulant therapy [ 13 , 14 ] and can be a possible cause of cerebral embolism anytime after lung resection. In some institutions, they had implemented routine postoperative anti-coagulation therapy in patients following VATS-LUL.…”