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盆腔静脉曲张放射栓塞术后肺胶水栓塞:一例报告

Pulmonary glue embolism after radiological embolization of pelvic varices: a case report.

作者信息

Longueville Elise, Dury Sandra, Ancel Julien, Attali Jonathan, Larad-Riffault Rahma, Pierrot Camille, Perotin Jeanne-Marie, Deslee Gaetan

机构信息

Department of Respiratory medicine, University Hospital of Reims, 45, rue Cognacq Jay Reims Cedex, Reims, 51092, France.

INSERM UMR-S 1250, Reims, France.

出版信息

BMC Pulm Med. 2025 Jul 28;25(1):360. doi: 10.1186/s12890-025-03867-8.

Abstract

BACKGROUND

Non-thrombotic pulmonary embolism (NTPE) is defined as embolization in the pulmonary circulation of biological or non-biological substances and foreign bodies. The migration of glue in the pulmonary circulation during interventional procedures is unusual and has been reported mainly after gastroenterological procedures. The most severe cases of NTPE can be life-threatening.

CASE PRESENTATION

A 31-year-old woman developed respiratory failure 24 h after radiological embolization of pelvic varices. Glue embolization was detected during the intervention and was confirmed on a chest CT scan showing multiple bilateral hyperdense elements up to sub-pleural regions. The patient developed respiratory symptoms 24 h after the procedure, progressively worsening with oxygen requirement up to 6 L/min. A follow-up chest CT angiography showed a thrombotic pulmonary embolism. Treatments included curative anticoagulation, antibiotherapy, corticosteroids, and oxygen, leading to improvement after 10 days of treatment.

CONCLUSIONS

This case report highlights that NTPE can occur after all interventional procedures using glue including pelvic procedures and can be complicated by thrombotic pulmonary embolism.

摘要

背景

非血栓性肺栓塞(NTPE)被定义为生物或非生物物质及异物在肺循环中的栓塞。介入操作过程中胶水在肺循环中的迁移并不常见,主要在胃肠介入操作后有相关报道。NTPE最严重的情况可能危及生命。

病例介绍

一名31岁女性在盆腔静脉曲张放射栓塞术后24小时出现呼吸衰竭。介入过程中检测到胶水栓塞,胸部CT扫描证实,显示双侧多个高密度影直至胸膜下区域。患者术后24小时出现呼吸道症状,吸氧需求逐渐增加至6升/分钟,病情逐渐恶化。后续胸部CT血管造影显示为血栓性肺栓塞。治疗包括根治性抗凝、抗生素治疗、使用皮质类固醇和吸氧,治疗10天后病情好转。

结论

本病例报告强调所有使用胶水的介入操作(包括盆腔操作)后都可能发生NTPE,且可能并发血栓性肺栓塞。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a490/12302744/8cd915d217ce/12890_2025_3867_Fig1_HTML.jpg

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