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Pulmonary Embolism after Bilateral Upper Limb Surgeries: A Case Report and Review of Literature 预览

Pulmonary Embolism after Bilateral Upper Limb Surgeries: A Case Report and Review of Literature
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摘要 Pulmonary embolism following upper limb surgery is a very rare complication. Here we present a unique case report of a 54-year-old young, fit and healthy, and non-smoker male who developed bilateral pulmonary embolism (PE) 26 days post-operatively with no associated upper or lower limb Deep Vein Thrombosis (DVT). This patient had minimal preoperative as well as intra-operative risk factors. He did not develop any thromboembolic symptoms until the 26th-day post-surgery when he developed sudden, sharp, pleuritic chest pain and laboured breathing. Initial baseline bloods showed a raised D-Dimer and the patient subsequently had a CT pulmonary angiogram that confirmed the presence of bilateral massive PEs. However, subsequent extremity ultrasound showed no upper or lower deep venous thrombosis. Thorough review of literature suggests that sudden development of PEs after upper limb surgery is possible, with a few cases being reported in the past. Symptoms such as sudden upper limb swelling, troubled breathing and systemic symptoms should be evaluated aggressively with a CT pulmonary angiogram, given the fact that an ultrasound of the extremities may be negative for deep venous thrombosis. Pulmonary embolism following upper limb surgery is a very rare complication. Here we present a unique case report of a 54-year-old young, fit and healthy, and non-smoker male who developed bilateral pulmonary embolism (PE) 26 days post-operatively with no associated upper or lower limb Deep Vein Thrombosis (DVT). This patient had minimal preoperative as well as intra-operative risk factors. He did not develop any thromboembolic symptoms until the 26th-day post-surgery when he developed sudden, sharp, pleuritic chest pain and laboured breathing. Initial baseline bloods showed a raised D-Dimer and the patient subsequently had a CT pulmonary angiogram that confirmed the presence of bilateral massive PEs. However, subsequent extremity ultrasound showed no upper or lower deep venous thrombosis. Thorough review of literature suggests that sudden development of PEs after upper limb surgery is possible, with a few cases being reported in the past. Symptoms such as sudden upper limb swelling, troubled breathing and systemic symptoms should be evaluated aggressively with a CT pulmonary angiogram, given the fact that an ultrasound of the extremities may be negative for deep venous thrombosis.
作者 Mujeeb Rohilla Mohammad Waseem Beeharry Gurudat Sisodia Mujeeb Rohilla;Mohammad Waseem Beeharry;Gurudat Sisodia(Department of Trauma and Orthopaedics, Royal Surrey County Hospital, Guildford, UK)
出处 《外科学(英文)》 2019年第10期362-367,共6页 Surgical Science
关键词 CT PULMONARY ANGIOGRAM D-DIMER Deep VEIN THROMBOSIS PULMONARY EMBOLISM Ultrasound CT Pulmonary Angiogram D-Dimer Deep Vein Thrombosis Pulmonary Embolism Ultrasound
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