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Deep Venous Thrombosis and Pulmonary Thromboembolism Associated with a Huge Uterine Myoma

A Case Report

Munehito Ideishi, MD

Taku Nishimura, MD

Akira Kawamura, MD

Hideyuki Kamochi, MD

Hisafumi Tahara, MD

Yoshihiro Tsuchiya, MD

Kazuyuki Shirai, MD

Masanori Okabe, MD

Kikuo Arakawa, MD, FICA

Munehito Ideishi, MD

Department of Internal Medicine Fukuoka University School of Medicine 7-45-1 Nanakuma, Jonan-ku Fukuoka 814-0180 Japan

A 51-year-old woman with a large uterine myoma suffered from acute pulmonary throm boembolism. Venography revealed thrombosis in the right common iliac vein and almost complete obstruction of the left common iliac vein. The ascending lumbar vein showed collateral drainage. Treatment was initiated with continuous intravenous heparin sodium, and a Greenfield filter was inserted to prevent the extension of the pulmonary embolism during and after hysterectomy. After a total hysterectomy, venography revealed restora tion of patency in the bilateral common iliac veins, and no flow was seen in the ascending lumbar vein. Thorough clinical examinations failed to identify any other prothrombotic conditions. These results suggest that a large uterine myoma compressed veins in the pelvis, and the resulting impaired blood flow caused deep venous thrombosis and pulmonary thromboembolism.

Angiology, Vol. 51, No. 2, 161-166 (2000)
DOI: 10.1177/000331970005100210


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