Korean J Anesthesiol.  2009 Feb;56(2):211-216. 10.4097/kjae.2009.56.2.211.

Lethal pulmonary thromboembolism misdiagnosed as pneumonia: A case report

• Jeong YS
• Kang YJ

• KMID: 2299321
• DOI: http://doi.org/10.4097/kjae.2009.56.2.211

Abstract

Although pulmonary thromboembolism (PTE) is not rare, unfortunately for anesthesiologists, the signs and symptoms of PTE are unreliable and nonspecific. PTE is a potentially lethal condition without an accurate diagnosis and prompt treatment. We report a case of PTE misdiagnosed as simple pneumonia. A 60-year-old female, not receiving prophylactic anticoagulant therapy, underwent elective surgery for a left proximal tibial fracture. During induction of general anesthesia, a temporary bronchospasm occurred and subsided quickly. Because vital signs were stable and patient monitoring was normal, we did not identify a serious hypercarbic condition. After surgery, a massive hemoptysis occurred and the patient expired due to cardiopulmonary collapse. According to autopsy, the cause of death was a PTE originating in deep vein thrombosis.

Keyword

Bronchospasm; Deep vein thrombosis; Pulmonary thromboembolism

MeSH Terms

Anesthesia, General
Autopsy
Bronchial Spasm
Cause of Death
Female
Hemoptysis
Humans
Middle Aged
Monitoring, Physiologic
Pneumonia
Pulmonary Embolism
Tibial Fractures
Venous Thrombosis
Vital Signs