Bilateral pulmonary emboli

Case contributed by Anson Chan
Diagnosis almost certain


2-day history of dyspnea with significant oxygen requirement. Positive D-dimer study.

Patient Data

Age: 90 years
Gender: Female

CT pulmonary angiogram


Large emboli within the bifurcations of the bilateral pulmonary arteries extending into the upper and lower lobe branches.

Dilated main pulmonary arteries and right heart chambers.

Contrast medium reflux into the IVC and hepatic veins.

Horizontal blood/contrast medium level in the IVC indicates stasis.

Hiatus hernia.

Case Discussion

Classic CT findings of large, bilateral pulmonary emboli. After the radiological diagnosis was made, the patient was commenced on treatment with therapeutic dose enoxaparin.

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