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Korean Journal of Anesthesiology 2009;56(2):211-216.
DOI: https://doi.org/10.4097/kjae.2009.56.2.211   
Lethal pulmonary thromboembolism misdiagnosed as pneumonia: A case report.
Yoo Sung Jeong, Yang Ja Kang
Department of Anesthesiology and Pain Medicine, Hanil General Hospital, Seoul, Korea. maria-85@hanmail.net
Abstract
Although pulmonary thromboembolism (PTE) is not rare, unfortunately for anesthesiologists, the signs and symptoms of PTE are unreliable and nonspecific. PTE is a potentially lethal condition without an accurate diagnosis and prompt treatment. We report a case of PTE misdiagnosed as simple pneumonia. A 60-year-old female, not receiving prophylactic anticoagulant therapy, underwent elective surgery for a left proximal tibial fracture. During induction of general anesthesia, a temporary bronchospasm occurred and subsided quickly. Because vital signs were stable and patient monitoring was normal, we did not identify a serious hypercarbic condition. After surgery, a massive hemoptysis occurred and the patient expired due to cardiopulmonary collapse. According to autopsy, the cause of death was a PTE originating in deep vein thrombosis.
Key Words: Bronchospasm; Deep vein thrombosis; Pulmonary thromboembolism


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