Kaykisiz Eylem Kuday, Unluer Erden Erol, Eser Utku
Department of Emergency Medicine, Bitlis State Hospital, Bitlis, Turkey.
Department of Emergency Medicine, Usak University Faculty of Medicine, Usak, Turkey.
Pan Afr Med J. 2018 Aug 17;30:279. doi: 10.11604/pamj.2018.30.279.16283. eCollection 2018.
Acute pulmonary embolism (PE) diagnosis is a challenging task, despite the advanced diagnostic methods for both clinicians and radiologists. Awareness of the "hyperdense lumen sign" in patients obtained un-enhanced computarized tomography (CT) of chest mayhelp to establish an acute PE diagnosis, especially in clinically non suspected PE patients. A 78-year-old woman was brought to our emergency department (ED) with an aphasia complaint. The patient's dizziness improved in ED. Neurological examination returned to base line status but sinus tachycardia and low saturation value on room air were continuing. Un-enhanced CT of the chest demonstrates hyperdense material within the right main pulmonary artery. Contrast-enhanced CTPA demonstrated hypodense filling defect within the rigth main pulmonary artery consistent with PE. Independent of the patient's complaint, the measurement of all vital signs is important especially in elderly patients. Emergency physicians have to be aware of that the "hyperdense lumen sign" may point out PE and should be prevented from delayed recognition.
尽管有先进的诊断方法可供临床医生和放射科医生使用，但急性肺栓塞（PE）的诊断仍是一项具有挑战性的任务。在胸部非增强计算机断层扫描（CT）中发现患者存在“高密度管腔征”，可能有助于确诊急性肺栓塞，尤其是在临床未怀疑肺栓塞的患者中。一名78岁女性因失语症状被送至我院急诊科。患者在急诊科时头晕症状有所改善。神经系统检查恢复至基线状态，但窦性心动过速和室内空气中的低饱和度值仍持续存在。胸部非增强CT显示右主肺动脉内有高密度物质。对比增强CT肺动脉造影（CTPA）显示右主肺动脉内有低密度充盈缺损，符合肺栓塞表现。无论患者的主诉如何，测量所有生命体征都很重要，尤其是在老年患者中。急诊医生必须意识到“高密度管腔征”可能提示肺栓塞，应避免延误诊断。
