{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T06:02:20Z","timestamp":1794376940321,"version":"4.9.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,3,1]],"date-time":"2022-03-01T00:00:00Z","timestamp":1646092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:00:00Z","timestamp":1644451200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Venous thromboembolism (VTE) is a serious postoperative complication with potentially fatal outcome. However, asymptomatic VTE is difficult to diagnose and is often discovered by chance. We report a case of suspected VTE diagnosed based on prolonged fever after surgery and discuss the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Presentation of case:<\/jats:title>\n                    <jats:p>A 48-year-old man was referred to us with a diagnosis of gastric cancer. Upper gastrointestinal endoscopy revealed a neoplastic lesion from the anterior wall of the mid-gastric mass to the upper part of the gastric body, and biopsy revealed adenocarcinoma. Contrast-enhanced computed tomography (CT) showed no obvious distant metastasis. The preoperative diagnosis was gastric cancer, cT4aN1M0 cStage III, and radical surgery was performed. During surgery, an intermittent pneumatic compression pump was used. Subcutaneous injection of enoxaparin was started postoperatively. A high fever continued on postoperative day 4, and high D-dimer level of 14.3 \u03bcg\/mL was found. Contrast-enhanced CT scanning showed thrombus in the left upper lobe pulmonary artery A4\/5. Lower extremity venous ultrasonography revealed a thrombus in the right soleal vein, and apixaban 20 mg\/day was started that day. Thereafter, fever resolved quickly, and the D-dimer level gradually decreased. The patient was discharged from hospital on day 21 having made good progress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>It sould be rememberd that there are VTE found in persistent fever after gastric cancer surgery. The main complaint was simply fever, and the fever disappeared with anticoagulant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This cases suggests the importance of perioperative measures against VTE. Peri operative treatment with apixaban was safe and effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2022.106836","type":"journal-article","created":{"date-parts":[[2022,2,14]],"date-time":"2022-02-14T01:57:29Z","timestamp":1644803849000},"page":"106836","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Asymptomatic pulmonary thromboembolism diagnosed based on prolonged fever after gastric cancer surgery"],"prefix":"10.1097","volume":"92","author":[{"given":"Masahide","family":"Endo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuta","family":"Sato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinya","family":"Ohno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-27-20260310","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1001\/archinte.160.6.809","article-title":"Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study","volume":"160","author":"Heit","year":"2000","journal-title":"Arch. Intern. Med"},{"key":"R2-27-20260310","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1001\/jama.293.6.715","article-title":"Malignancies, prothrombotic mutations, and the risk of venous thrombosis","volume":"293","author":"Blom","year":"2005","journal-title":"JAMA"},{"key":"R3-27-20260310","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1111\/j.1538-7836.2006.01786.x","article-title":"Incidence of venous thromboembolism following major abdominal surgery: a multi-center, prospective epidemiological study in Japan","volume":"4","author":"Sakon","year":"2006","journal-title":"J. Thromb. Haemost"},{"key":"R4-27-20260310","doi-asserted-by":"crossref","first-page":"e566","DOI":"10.1016\/S1470-2045(19)30336-5","article-title":"2019 international clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism in patients with cancer","volume":"20","author":"Farge","year":"2019","journal-title":"Lancet Oncol"},{"key":"R5-27-20260310","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/01.sla.0000193959.44677.48","article-title":"A clinical outcome-based prospective study on venous thromboembolism after cancer surgery: the @RISTOS project","volume":"243","author":"Agnelli","year":"2006","journal-title":"Ann. Surg"},{"key":"R6-27-20260310","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1016\/j.jacc.2010.05.071","article-title":"Clinical characteristics, management, and outcomes of patients diagnosed with acute pulmonary embolism in the emergency department: initial report of EMPEROR (Multicenter emergency medicine pulmonary embolism in the real world Registry)","volume":"57","author":"Pollack","year":"2011","journal-title":"J. Am. Coll. Cardiol"},{"key":"R7-27-20260310","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/S0140-6736(08)60594-2","article-title":"Diagnosis of pulmonary embolism by multidetector CT alone or combined with venous ultrasonography of the leg: a randomised non-inferiority trial","volume":"371","author":"Righini","year":"2008","journal-title":"Lancet"},{"key":"R8-27-20260310","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1001\/jama.295.2.172","article-title":"Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography","volume":"295","author":"van Belle","year":"2006","journal-title":"JAMA"},{"key":"R9-27-20260310","doi-asserted-by":"crossref","first-page":"1244","DOI":"10.1111\/j.1538-7836.2004.00795.x","article-title":"Diagnosing pulmonary embolism: running after the decreasing prevalence of cases among suspected patients","volume":"2","author":"Le Gal","year":"2004","journal-title":"J. Thromb. Haemost"},{"key":"R10-27-20260310","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1111\/j.1538-7836.2007.02328.x","article-title":"Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review","volume":"5","author":"Di Nisio","year":"2007","journal-title":"J. Thromb. Haemost"},{"key":"R11-27-20260310","doi-asserted-by":"crossref","first-page":"589","DOI":"10.7326\/0003-4819-140-8-200404200-00005","article-title":"D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review","volume":"140","author":"Stein","year":"2004","journal-title":"J. Ann. Intern. Med"},{"key":"R12-27-20260310","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1200\/JCO.19.01461","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: ASCO clinical practice guideline update","volume":"38","author":"Key","year":"2020","journal-title":"J. Clin. Oncol"},{"key":"R13-27-20260310","doi-asserted-by":"crossref","first-page":"2615","DOI":"10.21873\/anticanres.13385","article-title":"Efficacy and safety of enoxaparin for prophylaxis of postoperative venous thromboembolism after esophagectomy: a single-center prospective randomized controlled phase II study","volume":"39","author":"Tanaka","year":"2019","journal-title":"Anticancer Res"},{"key":"R14-27-20260310","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1084\/jem.20112322","article-title":"Monocytes, neutrophils, and platelets cooperate to initiate and propagate venous thrombosis in mice in vivo","volume":"209","author":"von Br\u00fchl","year":"2012","journal-title":"J. Exp. Med"},{"key":"R15-27-20260310","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1016\/0002-9343(79)90396-6","article-title":"Fever and pulmonary thromboembolism","volume":"67","author":"Murray","year":"1979","journal-title":"Am. J. Med"},{"key":"R16-27-20260310","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1378\/chest.117.1.39","article-title":"Fever in acute pulmonary embolism","volume":"117","author":"Stein","year":"2000","journal-title":"Chest"},{"key":"R17-27-20260310","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1007\/s11239-011-0604-7","article-title":"Fever and deep venous thrombosis. Findings from the RIETE registry","volume":"32","author":"Barba","year":"2011","journal-title":"J. Thromb. Thrombolysis"},{"key":"R18-27-20260310","doi-asserted-by":"crossref","first-page":"vi85","DOI":"10.1093\/annonc\/mdr392","article-title":"ESMO guidelines working group. Management of venous thromboembolism (VTE) in cancer patients: ESMO clinical practice guidelines","volume":"22","author":"Mandal\u00e0","year":"2011","journal-title":"Ann. Oncol"},{"key":"R19-27-20260310","doi-asserted-by":"crossref","first-page":"714","DOI":"10.6004\/jnccn.2011.0062","article-title":"Venous thromboembolic disease","volume":"9","author":"Streiff","year":"2011","journal-title":"J. Natl. Compr. Cancer Netw"},{"key":"R20-27-20260310","doi-asserted-by":"crossref","first-page":"654","DOI":"10.1200\/JCO.2014.59.7351","article-title":"Venous thromboembolism prophylaxis and treatment in patients with cancer: american society of clinical oncology clinical practice guideline update 2014","volume":"33","author":"Lyman","year":"2015","journal-title":"J. Clin. Oncol"},{"key":"R21-27-20260310","doi-asserted-by":"crossref","first-page":"e452","DOI":"10.1016\/S1470-2045(16)30369-2","article-title":"International clinical practice guidelines including guidance for direct oral anticoagulants in the treatment and prophylaxis of venous thromboembolism in patients with cancer","volume":"17","author":"Farge","year":"2016","journal-title":"Lancet Oncol"},{"key":"R22-27-20260310","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1016\/j.chest.2015.11.026","article-title":"Antithrombotic therapy for VTE disease. CHEST guidelines and expert panel report","volume":"149","author":"Kearon","year":"2016","journal-title":"Chest"},{"key":"R23-27-20260310","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1056\/NEJMoa025313","article-title":"Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer","volume":"349","author":"Lee","year":"2003","journal-title":"N. Engl. J. Med"},{"key":"R24-27-20260310","doi-asserted-by":"crossref","first-page":"1599","DOI":"10.1056\/NEJMoa1915103","article-title":"Apixaban for the treatment of venous thromboembolism associated with cancer","volume":"382","author":"Agnelli","year":"2020","journal-title":"N. Engl. J. Med"},{"key":"R25-27-20260310","doi-asserted-by":"crossref","first-page":"e545","DOI":"10.1016\/j.chest.2021.07.055","article-title":"Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report","volume":"160","author":"Stevens","year":"2021","journal-title":"Chest"},{"key":"R26-27-20260310","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"International Journal of Surgery"}],"container-title":["International Journal of Surgery Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222000827?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2210261222000827?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.106836","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:04:42Z","timestamp":1773137082000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1016\/j.ijscr.2022.106836"}},"subtitle":["A case report with literature review"],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":26,"journal-issue":{"issue":"C","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1016\/j.ijscr.2022.106836","relation":{},"ISSN":["2210-2612"],"issn-type":[{"value":"2210-2612","type":"print"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}