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Case Reports
. 2012 May;35(3):178-81.
doi: 10.1179/2045772312Y.0000000010.

Simultaneously diagnosed pulmonary thromboembolism and hemopericardium in a man with thoracic spinal cord injury

Jae-Young Han  1 , Hyo-Jeong Seon, In-Sung Choi, Youngkeun Ahn, Myung-Ho Jeong, Sam-Gyu Lee
Affiliations
Case Reports

Simultaneously diagnosed pulmonary thromboembolism and hemopericardium in a man with thoracic spinal cord injury

Jae-Young Han et al. J Spinal Cord Med. 2012 May.

Abstract

Background: Simultaneous pulmonary thromboembolism (PTE) and hemopericardium is a rare but life-threatening condition. As hemopericardium is a contraindication to anticoagulation treatment, it is challenging to handle both conditions together.

Objective: The objective of the study was to report a rare case of a man with thoracic spinal cord injury presenting with simultaneous PTE and hemopericardium.

Design: Case report.

Subject: A 43-year-old man with incomplete T9 paraplegia (American Spinal Injury Association Impairment Scale D) complained of fever one and a half months after spinal cord injury sustained in a fall.

Findings: During evaluation of fever origin, chest computed tomography and transthoracic echocardiogram revealed simultaneous PTE and hemopericardium. After serial echocardiograms over 2 days demonstrated stability, intravenous heparin, and oral warfarin were administered and his medical status was observed closely. Ultimately, both conditions improved without significant complications.

Conclusion: We report successful treatment of man with acute spinal cord injury who presented with simultaneously diagnosed PTE and hemopericardium, a rare complication involving two distinct and opposing pathological mechanisms and conflicting treatments.

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Figures

Figure 1
Figure 1
Chest CT with contrast showed low-attenuation filling defects in both main pulmonary arteries (left arrow) and considerable amount of pericardial effusion (right arrow) with iso-attenuation compared with intra-cardiac blood on pre-contrast image.
Figure 2
Figure 2
Transthoracic echocardiogram showed pericardial effusion to the posterior wall of the left ventricle (double-headed arrow).
Figure 3
Figure 3
Ten months later, chest CT with contrast showed complete absorption of previously seen hemopericardium and no recurrence of PTE.
See this image and copyright information in PMC

References

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