Pulmonary embolism - with saddle thrombus

Case contributed by Bruno Di Muzio


High speed MVA. Morbid obesity. Acute respiratory distress.

Patient Data

Age: 42-year-old
Gender: Male

CT Pulmonary Angiography



There is diagnostic contrast opacification of the pulmonary arteries. Saddle thrombus within the pulmonary trunk bifurcation and multiple pulmonary emboli within the main pulmonary arteries ramification, especially occluding all the branches to the left lower lobe. Pulmonary trunk is enlarged.

Small focus of opacification in the medial left lower lobe segment, nonspecific, may be related with the infarct. The lungs are otherwise clear.

The pleural spaces are clear. There is no lymph node enlargement or other mediastinal abnormality.

Fatty liver is demonstrated in the partially imaged upper abdomen.

Conclusion: Massive bilateral pulmonary embolism.

The treating team was contacted and are aware of the findings of this exam.

Case Discussion

Typical findings of massive pulmonary thromboembolism with a saddle embolus laying over the pulmonary trunk bifurcation. 

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