Anyfantakis Dimitrios, Karona Paraskevi, Kastanaki Pagona, Kourakos Athanasios, Kastanakis Miltiades
Primary Care Department, Primary Health Care Centre of Kissamos, Chania, Crete, Greece.
First Department of Surgery, Saint George General Hospital of Chania, Crete, Greece.
Med Pharm Rep. 2019 Jan;92(1):83-86. doi: 10.15386/cjmed-1031. Epub 2019 Jan 15.
Paradoxical embolism is an uncommon cause of arterial occlusion with a high mortality burden. Current evidence suggests that patent foramen ovale is the most important etiological factor of paradoxical embolism, by acting as a pathway for a thromboembolic material originating from the peripheral veins, passing through the lungs and entering the systemic circulation. Here we present a case of paradoxical embolism in the mesenteric and renal arteries associated with pulmonary embolism and deep vein thrombosis in an elderly woman with no predisposing risk factor. A diagnosis of paradoxical embolism was considered and the presence of a patent foramen ovale was consequently confirmed with a transesophageal echocardiography. Urgent thrombolysis saved the life of the patient. Paradoxical embolism represents an emergency and therefore prompt diagnosis and initiation of therapy may prevent adverse outcomes.
反常栓塞是动脉闭塞的一种罕见原因，具有很高的致死率。目前的证据表明，卵圆孔未闭是反常栓塞最重要的病因，它为源自外周静脉的血栓栓塞物质提供了一条途径，使其穿过肺部并进入体循环。在此，我们报告一例老年女性肠系膜和肾动脉反常栓塞病例，该病例同时伴有肺栓塞和深静脉血栓形成，且无诱发危险因素。考虑诊断为反常栓塞，随后经食管超声心动图证实存在卵圆孔未闭。紧急溶栓挽救了患者的生命。反常栓塞是一种急症，因此及时诊断和开始治疗可预防不良后果。
