An unusual cause of pulmonary embolism following blunt chest trauma: a case study
DOI:
https://doi.org/10.29352/mill0224.34653Keywords:
pulmonary embolism; trauma; hypercoagulable state; tissue injury; catheter-directed thrombolysisAbstract
Introduction: Chest injury resulting from thoracic trauma experienced by an individual is presented in this study. The results obtained from this analysis conducted retrospectively are anticipated to contribute to raising awareness of early diagnosis of embolism in the context of trauma.
Objective: Pulmonary embolism remains a disease that needs clinical suspicion to prevent mortality and morbidity. More so in young individuals, suspicion is very low as compared to old age individuals with multiple co-morbid conditions. There is a high risk of mortality associated with Pulmonary embolism in case of not detected and treated in the early stage.
Methods: This document outlines a case study involving a young male patient who exhibited sudden breathlessness after experiencing blunt chest trauma. The patient was diagnosed with pulmonary thromboembolism later on.
Results: The patient was discharged on the novel oral anticoagulant Rivaroxaban. It is one of the first available direct factor Xa inhibitors, recommended for use in venous thromboembolism. It allows predictable anticoagulation, and routine coagulation monitoring is not required, unlike warfarin.
Conclusion: The authors concluded that the development of a hypercoagulable state leads to the occurrence of pulmonary embolism triggered by epithelial injury following a traumatic event. In the case of submissive pulmonary embolism, catheter-directed thrombolysis is considered useful when systemic thrombolysis poses a potential risk of hemorrhage.
Downloads
References
Electronic Medicines Compendium (2023). Xarelto 20mg film-coated tablets. EMC. https://www.medicines.org.uk/emc/product/2793/smpc#companyDetails
Gibson, C. M. (2020). Pulmonary embolism natural history, complications and prognosis. https://encurtador.com.br/zeLlr
Jancin, B. (2011). Pulmonary Embolism Risk Higher With Traumatic Chest Injury. MDedge. https://www.mdedge.com/content/pulmonary-embolism-risk-higher-traumatic-chest-injury
Kuo, W. T., Gould, M. K., Louie, J. D., Rosenberg, J. K., Sze, D. Y., & Hofmann, L. V. (2009). Catheter-directed therapy for the treatment of massive pulmonary embolism: Systematic review and meta-analysis of modern techniques. Journal of Vascular and Interventional Radiology: JVIR, 20(11), 1431–1440. https://doi.org/10.1016/j.jvir.2009.08.002
Lewis, C., Mustafa, D., Wilson, K., & Danner, O. (2013). Pulmonary embolism diagnosed immediately following blunt trauma. International Journal of Case Reports and Images, 4(5), 248-251. doi:10.5348/ijcri-2013-05-305-CR-2. https://www.ijcasereportsandimages.com/archive/2013/005-2013-ijcri/002-05-2013-lewis/ijcri-00205201322-lewis-full-text.php
Marx, J. A. (2007). Pulmonary Embolism Can Occur Early After Trauma. J Trauma, 63(620). https://www.jwatch.org/em200710260000001/2007/10/26/pulmonary-embolism-can-occur-early-after-trauma
Menaker, J., Stein, D. M., & Scalea, T. M. (2007). Incidence of early pulmonary embolism after injury. The Journal of Trauma, 63(3), 620–624. https://doi.org/10.1097/TA.0b013e31812f60aa
O’Malley, K. F., & Ross, S. E. (1990). Pulmonary embolism in major trauma patients. The Journal of Trauma, 30(6), 748–750. https://doi.org/10.1097/00005373-199006000-00018
Ouellette, D. R. (2020). Pulmonary Embolism (PE). Medscape, 300901, 1-59. doi:https://emedicine.medscape.com/article/300901
Selby, R., Geerts, W., Ofosu, F. A., Craven, S., Dewar, L., Phillips, A., & Szalai, J. P. (2009). Hypercoagulability after trauma: Hemostatic changes and relationship to venous thromboembolism. Thrombosis Research, 124(3), 281–287. https://doi.org/10.1016/j.thromres.2008.10.002
Sharma, G., Kothari, S. S., & Bahl, V. K. (2002). Thrombolytic therapy for acute pulmonary embolism. Indian Heart Journal, 54(6), 667–671. https://pubmed.ncbi.nlm.nih.gov/12674177/
Siddiqui, T., Asim, M., Ahmed, K., Mathradikkal, S., Bakhsh, Z., Masood, M., Al-Hassani, A., Nabir, S., Ahmed, N., Strandvik, G., El-Menyar, A., & Al-Thani, H. (2022). Clinical Characteristics and Risk Factors for Early versus Late Pulmonary Embolism in Trauma Patients: A Retrospective, Observational Study. International Journal of General Medicine, 15, 7867–7878. https://doi.org/10.2147/IJGM.S387880
Simpson, D., Siddiqui, M. A. A., Scott, L. J., & Hilleman, D. E. (2006). Reteplase: A review of its use in the management of thrombotic occlusive disorders. American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions, 6(4), 265–285. https://doi.org/10.2165/00129784-200606040-00007
ten Wolde, M., Söhne, M., Quak, E., Mac Gillavry, M. R., & Büller, H. R. (2004). Prognostic value of echocardiographically assessed right ventricular dysfunction in patients with pulmonary embolism. Archives of Internal Medicine, 164(15), 1685–1689. https://doi.org/10.1001/archinte.164.15.1685
U Nazir, P. B. (2022). Role of thrombolytics in the management of submassive pulmonary embolism. OA Critical Care, 2(1).
Van Gent, J.-M., Zander, A. L., Olson, E. J., Shackford, S. R., Dunne, C. E., Sise, C. B., Badiee, J., Schechter, M. S., & Sise, M. J. (2014). Pulmonary embolism without deep venous thrombosis: De novo or missed deep venous thrombosis? The Journal of Trauma and Acute Care Surgery, 76(5), 1270–1274. https://doi.org/10.1097/TA.0000000000000233
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Millenium - Journal of Education, Technologies, and Health
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who submit proposals for this journal agree to the following terms:
a) Articles are published under the Licença Creative Commons (CC BY 4.0), in full open-access, without any cost or fees of any kind to the author or the reader;
b) The authors retain copyright and grant the journal right of first publication, allowing the free sharing of work, provided it is correctly attributed the authorship and initial publication in this journal;
c) The authors are permitted to take on additional contracts separately for non-exclusive distribution of the version of the work published in this journal (eg, post it to an institutional repository or as a book), with an acknowledgment of its initial publication in this journal;
d) Authors are permitted and encouraged to publish and distribute their work online (eg, in institutional repositories or on their website) as it can lead to productive exchanges, as well as increase the impact and citation of published work
Documents required for submission
Article template (Editable format)
