Pulmonary embolism due to compression of the inferior vena cava by a hepatic hemangioma.

AUTOR(ES)

Paolillo, V

RESUMO

We describe a 35-year-old man who had a pulmonary embolism with thrombosis of the inferior vena cava, apparently resulting from compression by a hepatic hemangioma. The diagnosis of pulmonary embolism was confirmed by pulmonary angiography; however, the hemangioma was detected only incidentally, as a hyperechoic mass, during an echocardiogram for intracardiac thrombosis. Abdominal sonography, computed tomography, celiac angiography, technetium 99m-labeled red blood cell scintigraphy, and ultrasound-guided liver biopsy all assisted in the diagnosis of hepatic hemangioma and its compression of the inferior vena cava. Because of the multisegmental and perihilar involvement of the tumor, surgery was not performed. For dissolution of the clots, the patient was given thrombolytic therapy followed by heparin administration. He was then placed on long-term warfarin therapy and is well after 5 years; the size of the hemangioma is unchanged. Cases of pulmonary embolism due to diseases of the upper abdominal organs are rare and probably underestimated. This case stresses the need for a systematic investigation of the abdomen when a pulmonary embolism is present without evidence of deep vein thrombosis.

Documentos Relacionados

• Treatment of hepatic alveolar echinococcosis infringing the inferior vena cava
• Compression of the Superior Vena Cava by a Mediastinal Lipoma
• Coarctation of the Inferior Vena Cava
• ANOMALOUS PULMONARY VENOUS DRAINAGE OF THE RIGHT LUNG INTO THE INFERIOR VENA CAVA
• Detection of pulmonary hypertension by Doppler echocardiography of the inferior vena cava in chronic airflow obstruction.