Atypical presentation of pulmonary embolism masquerading as abdominal pain

Abstract

This case report highlights a rare presentation of Pulmonary Embolism (PE) with atypical abdominal pain, emphasizing the challenges in timely diagnosis. A female patient in her early eighties presented with left abdomen pain, initially treated for Urinary Tract Infection (UTI), and later accurately diagnosed with PE through Computed Tomography Pulmonary Angiography (CTPA). The mechanisms of abdominal pain encompass many hypotheses such as right-sided heart failure-induced hepatic congestion, diaphragmatic irritation from the pulmonary lobe infraction, increased blood viscosity, and pulmonary hypertension-associated abdominal lymphedema. PE is a prominent cause of unexpected deaths in hospitalized patients, with misdiagnosis occurring in up to 70% of cases, often only discovered postmortem. The condition manifests through various symptoms, with dyspnoea and chest pain being the most common. Abdominal pain, though less frequent, has been documented with an incidence of 6.7% in previous studies.