J Korean Soc Emerg Med.  2017 Dec;28(6):676-681. 10.0000/jksem.2017.28.6.676.

Acute Pulmonary Embolism Associated with Transposition of the Inferior Vena Cava in a 14-year-old Boy

• Kwon HJ
• Shin JS
• Kim HS
• Lee K
• Kim SH

• KMID: 2403288
• DOI: http://doi.org/10.0000/jksem.2017.28.6.676

Abstract

Idiopathic venous thromboembolism (VTE) and pulmonary embolism (PE) are relatively infrequent in the pediatric population but are almost always associated with an underlying disease or risk factors, such as congenital or acquired coagulation abnormalities, autoimmune disorders, or malignancies. In the pediatric emergency department, VTE, and particularly, PE, are often less considered in differential diagnoses because of their low incidence. On the other hand, a delayed diagnosis can result in serious morbidity and mortality. Therefore, even if there are no well-known risk factors, it is important to consider the possibility of PE, whenever there are suspicious symptoms and signs. The transposition of the inferior vena cava (IVC) is one of the major anatomical variants among the spectrum of IVC malformations. Although most IVC malformations are clinically silent and are discovered incidentally on radiographs, they are associated with PE in rare cases. In the pediatric population, no cases of transposition of the IVC that was discovered by acute PE have been reported. We report a case of acute PE associated with a transposition of the IVC in a 14-year-old boy without intra-cardiac anomalies or coagulation abnormalities.

Keyword

Vena cava; Inferior; Pulmonary embolism; Vascular malformations; Congenital; Venous thromboembolism

MeSH Terms

Adolescent*
Delayed Diagnosis
Diagnosis, Differential
Emergency Service, Hospital
Hand
Humans
Incidence
Male*
Mortality
Pulmonary Embolism*
Risk Factors
Vascular Malformations
Vena Cava, Inferior*
Venous Thromboembolism