Department of Orthopaedic Surgery, The Third Affiliated Hospital of Xi'an Jiaotong University (Shaanxi Provincial People's Hospital), Xi'an, China.
Division of Computed Tomography, The Third Affiliated Hospital of Xi'an Jiaotong University (Shaanxi Provincial People's Hospital), Xi'an, China.
Orthop Surg. 2021 May;13(3):1119-1125. doi: 10.1111/os.12982. Epub 2021 Mar 14.
Pulmonary embolism (PE) is extremely rare after shoulder arthroscopy. However, early identification of the situation deserves attention due to its potential risk of causing death. By now, it is still difficult to detect the PE without symptoms and clear sources during the perioperative period.
We report here two cases of asymptomatic PE, both happening within 24 h after shoulder arthroscopy, without any detected deep venous thrombosis of extremities. It is suspected the cases were due to the abnormal decrease in partial pressures of oxygen and arterial oxygen saturation, and were confirmed by computed tomography pulmonary angiography. We also discuss the reason why the patients showed no related symptoms when PE occurred and perform a review of PE following shoulder arthroscopy.
This report highlights that PE could occur in the early phase after shoulder arthroscopy. An unexplained decrease in partial pressure of oxygen or arterial oxygen saturation should be considered seriously. The symptoms of PE might be masked due to patients' tolerance to hypoxia.
肩关节镜术后发生肺栓塞（PE）极为罕见。但因其存在致死风险，仍应重视围手术期无明显症状及明确来源的情况。目前，仍难以在无任何症状的情况下于围术期检测到 PE，且无法明确下肢深静脉血栓的来源。我们在此报告两例肩关节镜术后 24 小时内发生的无症状性 PE，均无明确的四肢深静脉血栓。疑似由于氧分压和动脉血氧饱和度的异常下降所致，通过肺部计算机断层扫描血管造影术得到确诊。我们还讨论了在发生 PE 时患者无相关症状的原因，并对肩关节镜术后发生 PE 的情况进行了回顾。
本报告强调了肩关节镜术后早期可能发生 PE。对于无法解释的氧分压或动脉血氧饱和度下降应予以重视。PE 的症状可能因患者对缺氧的耐受而被掩盖。
