Description of using transthoracic ultrasound in the diagnosis of low-risk pulmonary embolism in a patient after multiple trauma

Abstract

Abstract Introduction Pulmonary embolism (PE) is a clinical manifestation of venous thromboembolism. We present a case of low-risk pulmonary embolism in a patient suffering multiple trauma due to a traffic accident. Aim The aim of this work was to present and analyze the possibilities of using TUS for the diagnosis of low-risk PE. Case study A 29-year-old patient with multiple trauma following a traffic accident was admitted to our Intensive Care Unit. During hospitalization, the patient suffered transfusion-related complications following administration of fresh frozen plasma. This was further complicated by a tendency in the patient to be hypercoagulable. Hemolytic anemia was diagnosed. Transthoracic ultrasound (TUS) of lung performed on 16th day of hospitalization revealed an area of consolidation in the right middle lung lobe originating from the pleura, suggestive of PE. Results and discussion TUS can be used in the diagnosis of PE when computed tomography is inadvisable or unavailable. A diagnosis of PE is certain when two or more characteristic lesions are visualized, and is likely when one typical lesion is accompanied by pleural effusion. Conclusions (1) TUS is a safe, reproducible and inexpensive diagnostic tool. (2) The use of TUS in the diagnosis of PE is well documented, but requires further research including a larger sample size. (3) High sensitivity and specificity of TUS as compared to pulmonary angiography as a reference method, make it a reliable tool in the diagnosis of PE. (4) The lack of blood flow within the consolidated area allows for the exclusion of inflammatory lesions.