Incidental pulmonary embolism

Case contributed by Dr Antonio Rodrigues de Aguiar Neto

Presentation

Alcoholic patient with anorexia, nausea, and abdominal pain, associated with diarrhea for about one month.

Patient Data

Age: 60 years
Gender: Male

There are right-sided segmental lower lobe pulmonary arterial filling defects in contrast-enhanced CT of the abdomen and pelvis.

A CTPA image shows filling defects in the right lower lobe pulmonary artery segmental branches in keeping with acute pulmonary emboli.

There is not lung infarction, nor pleural effusion. 

Case Discussion

Pulmonary embolism remains mostly underdiagnosed due to nonspecific manifestations 1-4. With greater use of CT imaging, there is more detection of incidental pulmonary emboli in patients undergoing chest CT scans and abdominal CT scans for reasons other than the research of suspected pulmonary embolism 5-7. The radiologists should search for pulmonary embolism in the lower chest during the interpretation of enhanced abdominal CT 5.

The patient, in this case, had an incidental PE, which was documented on an abdomen and pelvis contrast-enhanced CT image and subsequently confirmed with a chest CT angiogram.

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