Saddle pulmonary embolism

Case contributed by Dr Mostafa Mahmoud El Feky

Presentation

Chest pain, dyspnea and DVT.

Patient Data

Age: 45
Gender: Male

CTA Pulmonary angiography

Modality: CT

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

Annotated images

Modality: CT

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 "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 with a thin rim of contrast. This applies to any venous thrombosis, while it was first described in pulmonary embolism in CTPA.

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Case Information

rID: 52092
Case created: 21st Mar 2017
Last edited: 12th May 2017
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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