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经支气管超声检查意外诊断为肺栓塞的有趣病例。

Interesting case of incidental diagnosis of pulmonary embolism by endobronchial ultrasonography.

作者信息

Subedi Ananta, Sharma Rakshya, Jamous Fady

机构信息

Internal Medicine, University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota, USA

Hospital Medicine, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota, USA.

出版信息

BMJ Case Rep. 2022 Dec 30;15(12):e253943. doi: 10.1136/bcr-2022-253943.

Abstract

Pulmonary embolism (PE) is the obstruction of the pulmonary artery or its branches, usually by a thrombus that originates in the lower extremity veins. PE is associated with high mortality risk. Here, we present the case of a patient who initially presented with dysphagia. Chest radiography revealed a lung nodule. Endobronchial ultrasonography (EBUS) was performed to evaluate the nodule, which revealed a pulmonary embolus. Subsequently, CT angiography of the chest was performed to confirm the diagnosis of PE. Anticoagulation therapy was initiated. The biopsy results were positive for lung adenocarcinoma. There are only few reported cases of PE diagnosed using EBUS. Here, the patient had not presented with the signs and symptoms of PE. Had PE not been diagnosed by EBUS, our patient could have potentially had a disastrous outcome. Moreover, this case shows that EBUS may be used for diagnosing PE.

摘要

肺栓塞(PE)是指肺动脉或其分支被阻塞,通常是由起源于下肢静脉的血栓所致。肺栓塞与高死亡风险相关。在此,我们报告一例最初表现为吞咽困难的患者。胸部X线检查发现一个肺结节。进行了支气管内超声检查(EBUS)以评估该结节,结果显示为肺栓塞。随后,进行了胸部CT血管造影以确诊肺栓塞。开始了抗凝治疗。活检结果显示肺腺癌呈阳性。仅有少数使用EBUS诊断肺栓塞的病例报道。在此,该患者并未表现出肺栓塞的体征和症状。若未通过EBUS诊断出肺栓塞,我们的患者可能会有灾难性后果。此外,该病例表明EBUS可用于诊断肺栓塞。

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