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Saddle pulmonary embolism

Case contributed by Mostafa Elfeky
Diagnosis certain

Presentation

Chest pain, dyspnea and deep vein thrombosis.

Patient Data

Age: 45 years
Gender: Male

CT pulmonary angiography

ct

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

Annotated images

ct

Multiple intraluminal hypodense filling defects are 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 that 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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