Nilgiri K Mithun, Orakkan Rishi G, Meshram Shailesh B
Department of Respiratory Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, IND.
Cureus. 2024 Jul 2;16(7):e63644. doi: 10.7759/cureus.63644. eCollection 2024 Jul.
Obstruction of the pulmonary artery or one of its branches, often due to thrombi from the deep veins of the lower extremities can result in a life-threatening condition known as pulmonary embolism. Pulmonary infarction, an unusual complication of pulmonary embolism occurs when the blood supply to lung tissue is obstructed, leading to tissue necrosis. An 80-year-old man presented with a cough, breathlessness, and generalized weakness. He was vitally stable with no oxygen requirement, which could have suggested an infective etiology like pneumonia or tuberculosis. However, the presence of calf tenderness prompted us to perform a venous Doppler ultrasonography, which revealed deep venous thrombosis. This, combined with right atrial and ventricular dilation and moderate pulmonary artery hypertension observed on transthoracic echocardiography (2D ECHO), led us to recommend a CT pulmonary angiography. The angiography revealed an uncommon presentation of pulmonary embolism with multiple pulmonary infarcts. Here, we chronicle an unusual case of pulmonary infarction secondary to pulmonary embolism, which presented radiologically as consolidation with an aseptic cavity, a rare and atypical triple occurrence.
肺动脉或其分支之一的阻塞,通常是由于来自下肢深静脉的血栓,可导致一种危及生命的状况,称为肺栓塞。肺梗死是肺栓塞的一种不常见并发症,当肺组织的血液供应受阻,导致组织坏死时就会发生。一名80岁男性出现咳嗽、呼吸困难和全身无力。他生命体征稳定,无需吸氧,这可能提示为感染性病因,如肺炎或肺结核。然而,小腿压痛的存在促使我们进行静脉多普勒超声检查,结果显示存在深静脉血栓形成。这与经胸超声心动图(二维超声心动图)观察到的右心房和心室扩张以及中度肺动脉高压相结合,促使我们建议进行CT肺动脉造影。造影显示肺栓塞伴有多处肺梗死的不常见表现。在此,我们记录了一例继发于肺栓塞的不寻常肺梗死病例,其影像学表现为实变伴无菌腔,这是一种罕见且非典型的三联征。