Goldhaber Nicole H, Lee Christopher S
Stetson Powell Orthopaedics and Sports Medicine, 191 S. Buena Vista Street, Suite 470, Burbank, CA 91505, USA.
Case Rep Orthop. 2014;2014:279082. doi: 10.1155/2014/279082. Epub 2014 Dec 7.
Pulmonary embolism (PE) following shoulder arthroscopy is a rare complication. We present a unique case report of a 43-year-old right-hand dominant female who developed a PE 41 days postoperatively with no associated upper or lower extremity DVT. The patient had minimal preoperative and intraoperative risk factors. Additionally, she had no thromboembolic symptoms postoperatively until 41 days following surgery when she developed sudden right-hand swelling, labored breathing, and abdominal pain. A stat pulmonary computed tomography (CT) angiogram of the chest revealed an acute PE in the right lower lobe, and subsequent extremity ultrasounds showed no upper or lower extremity deep vein thrombosis. After a thorough review of the literature, we present the first documented isolated PE following shoulder arthroscopy. Although rare, sudden development of an isolated PE is possible, and symptoms such as sudden hand swelling, trouble breathing, and systemic symptoms should be evaluated aggressively with a pulmonary CT angiogram given the fact that an extremity ultrasound may be negative for deep vein thrombosis.
肩关节镜检查后发生肺栓塞（PE）是一种罕见的并发症。我们报告一例独特病例，一名43岁右利手女性，术后41天发生肺栓塞，且无相关的上肢或下肢深静脉血栓形成（DVT）。该患者术前和术中危险因素极少。此外，术后直到第41天她出现右手突然肿胀、呼吸困难和腹痛之前，一直没有血栓栓塞症状。胸部急诊肺计算机断层扫描（CT）血管造影显示右下叶急性肺栓塞，随后的四肢超声检查显示上肢和下肢均无深静脉血栓形成。在对文献进行全面回顾后，我们呈现了首例有记录的肩关节镜检查后孤立性肺栓塞病例。尽管罕见，但孤立性肺栓塞仍有可能突然发生，鉴于四肢超声检查可能显示深静脉血栓形成阴性，对于突然出现的手部肿胀、呼吸困难和全身症状等情况，应积极进行肺部CT血管造影评估。
