Acute pulmonary embolism

Case contributed by Dr Antonio Rodrigues de Aguiar Neto

Presentation

Admitted to the emergency on the eighth postoperative day of cranial reconstruction and CSF fistula correction, with a sudden left motor deficit and low oxygen saturation.

Patient Data

Age: 65 years
Gender: Male
CT

Pulmonary angiography

Filling defects in the left upper lobe, middle lobe, and right lower lobe pulmonary artery's lobar and segmental branches in keeping with acute pulmonary emboli. 

There is an elevation of the right diaphragm and basal atelectasis in the right lower lobe periphery.

No pleural or pericardial effusion.

Case Discussion

Acute pulmonary embolism is a life-threatening complication of venous thromboembolic disease, which remains mostly underdiagnosed due to nonspecific manifestations 1-5. CTPA is the imaging modality of choice for prompt and reliable pulmonary embolism diagnosis, which is crucial to enable rapid treatment and guide patient management 1-4,6,7.

Eight days postoperatively, this patient had a sudden hypoxia episode, with strong clinical suspicion of pulmonary embolism, confirmed on CTPA.

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