Pulmonary embolism after shoulder arthroscopy

Abstract

Deep venous thrombosis and pulmonary embolism events are common complications following lower-extremity orthopedic surgery. Conversely, deep venous thrombosis and pulmonary embolism events are rare following upper-extremity surgery, specifically shoulder arthroscopy. The purpose of this article is to emphasize the necessity of performing a thorough preoperative workup to uncover possible risk factors for deep venous thrombosis/pulmonary embolism despite the rare occurrence of developing a pulmonary embolism following shoulder arthroscopy. This article describes 3 patients who developed a nonfatal pulmonary embolism following elective shoulder arthroscopy. All 3 surgeries were performed with the patient in the lateral decubitus position. No complications were noted intraoperatively. Symptoms appeared at postoperative days 14, 29, and 2, respectively. One patient demonstrated no risk factors for developing a pulmonary embolism, whereas the other 2 exhibited risk factors for deep venous thrombosis and pulmonary embolism. Pulmonary embolism is a rare but serious complication following shoulder arthroscopy. Shoulder surgeons should be aware of the presenting signs and symptoms. Mechanical or chemical prophylaxis should be administered for patients with identified coagulopathic risk factors. Although it is rare for patients to develop a pulmonary embolism following upper-extremity shoulder arthroscopy, orthopedic surgeons must be aware of the possibility that a pulmonary embolism can occur after elective, uncomplicated shoulder arthroscopy. Surgeons should consider prophylactic measures for patients with identified coagulopathy disorders.