Saddle pulmonary embolism

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Chest pain, dyspnoea and deep vein thrombosis.

Patient Data

Age: 45 years
Gender: Male
CT

CT pulmonary angiography

Large intraluminal filling defect (saddle thrombus) straddles the pulmonary artery bifurcation extending into the main pulmonary arteries partially occluding their lumens.

CT

Annotated images

Multiple intraluminal hypodense filling defects are also seen along the anterior and posterior segmental and subsegmental branches of the upper and lower pulmonary lobar arteries partially occluding their lumens.

Transverse sections of the thrombus inside the subsegmental branches surrounded with a rim of contrast refers to the "Polo Mint sign".

Case Discussion

Imaging features of a saddle pulmonary embolism, which refers to a large pulmonary embolism that straddles the bifurcation of the pulmonary trunk, extending into the left and right pulmonary arteries.

The Polo Mint sign refers to the appearance of a venous thrombosis on contrast-enhanced CT surrounded by a thin rim of contrast. This can be seen with any venous thrombosis, although it was first described in pulmonary embolism on CT pulmonary angiography.

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Case information

rID: 52092
Case created: 21st Mar 2017
Last edited: 28th Jan 2018
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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