Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report

Abstract

Pulmonary embolism (PE) is associated withconsiderable morbidity and mortality. Earlydiagnosis and prompt treatment is essential, 1 • 2however PE is rarely clinically diagnosed ortreated in children. Most clinically significant PE is notrecognized antemortem. 3 While its diagnosis remainsa challenge as the signs and symptoms can often benon-specific, an accurate diagnosis is essential for themanagement of this disease. It is known that a numberof non-invasive diagnostic tools are available for itsdetection nowadays. 1 • 2 .4 Even though multi-detectorspiral, also called helical, CT scanning is promisingand has been proven to be useful in diagnosing thiscondition with high sensitivity and specificity, 5 it isunavailable even in referral hospitals in Indonesia.The gold standard, pulmonary angiography, isconsidered as the procedure of choice to diagnose PE,but unfortunately it is invasive. Failure to diagnose PEaccurately and promptly can result in excess morbidityand death due to pulmonary hypertension (PH) andrecurrent venous thromboembolic events. Conversely,unnecessary anticoagulation therapy poses a riskwithout any benefit.2