Early bilateral pulmonary embolism in a polytrauma patient: About a case report.
Ann Med Surg (Lond) 2022;
78:103868. [PMID:
35734707 PMCID:
PMC9207082 DOI:
10.1016/j.amsu.2022.103868]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/20/2022] [Accepted: 05/22/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction
and importance: Venous thromboembolism (VTE) is a well-known complication in polytrauma patients, associated with a high rate of mortality and morbidity. Generally pulmonary embolism (PE) is most common between the fifth and seventh days following a significant trauma, and it is uncommon before the fourth day. Their management remains a challenge to physicians given the nature and risk of blood loss from the accompanying injuries must be considered while using anticoagulant therapy.
Case presentation
Here we present a case of acute pulmonary embolism in a previously healthy young woman that developed two days after a traumatic brain injury (TBI) and varying degrees of additional blunt thoracic trauma. An angio CT scan was used to make the diagnosis, and the patient was given anticoagulant medication with close monitoring and satisfactory outcomes.
Conclusion
Evidence suggests that early after trauma, a considerable number of trauma patients are hypercoagulable. In patients with unexplained dyspnea/hypoxia, clinicians should maintain a high index of suspicion and explore PE early after injury. In the case of traumatic brain injury patients with cerebral contusions, intraparenchymal haemorrhages, or subdural/extradural haemorrhages, the existence of post-traumatic PE adds to the problems.
Our aim was to investigate the (PE) in polytrauma patients: incidence, risk factors of early occurrence, management and outcomes.
Decision to anti-coagulate post traumatic PE is controversial, especially in polytrauma patients.
Anticoagulation decision is guided by interval repeat CT scan and clinical picture.
The presence of post traumatic PE poses further challenges in the management of traumatic brain injury patients with cerebral contusions, intraparenchymal haemorrhages or subdural/extradural haemorrhages.
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