A CASE OF INCARCERATED FEMORAL HERNIA ASSOCIATED WITH POLYCYTHEMIA VERA

An operative case of incrcerated femoral hernia associated with polycythemia vera (PV) is herein reported. A 76-year-old woman, who had been treated for PV with busulfan over the previous 7 years, developed an incarcerated femoral hernia and underwent partial resection of the small intestine along with herniorrhaphy under general anesthesia. The patient had been associated with severe bradycardia and malnutrition preoperatively, and also showed some mild respiratory failure postoperatively. However, the postoperative course was otherwise uneventful with no symptoms of disseminated intravascular coagulopathy or thrombosis, while prescribing a temporary pacemaker and intravenous administration of ulinastatin. The patient was discharged on the 15th postoperative day in good condition. Fifteen surgical cases of PV, including this case, have been reported in Japan and most of them were frequently accompanied with postoperative complications, which sometimes were fatal. Careful postoperative management of bleeding and any thrombotic complications therefore seems to be essential in successful management of the postoperative course in patients with polycythemia vera.