Abstract
BackgroundVenous thromboembolism, specifically pulmonary embolism, is a rare complication following elective pediatric orthopedic surgery. Bilateral pulmonary embolism with associated pulmonary hemorrhage/infarct without concomitant deep vein thrombosis has never been reported following routine anterior cruciate ligament reconstruction in an adolescent.Case presentationA 16-year-old white girl presented with acute onset shortness of breath and pleuritic chest pain 6 days following elective anterior cruciate ligament reconstruction. After performing a thorough work-up, she was diagnosed as having provoked bilateral pulmonary embolism with associated pulmonary hemorrhage without concomitant deep vein thrombosis. She was treated successfully with 3 months of anticoagulation therapy with daily Lovenox (enoxaparin) injections.ConclusionsSymptomatic bilateral pulmonary embolism may have a good prognosis if it is diagnosed early and treated appropriately. It is important to appreciate the risk of provoked thromboembolic events in healthy adolescents undergoing arthroscopic knee surgery.
Highlights
Venous thromboembolism, pulmonary embolism, is a rare complication following elective pediatric orthopedic surgery
We present the clinical history and outcomes of a 16-year-old girl who suffered from symptomatic bilateral lower lobe pulmonary emboli (PE) with associated pulmonary hemorrhage/ infarction following routine anterior cruciate ligament (ACL) reconstruction with bone-patellar tendon-bone autograft
The hematological team did recommend to our patient that she did not use an estrogen-containing oral contraceptive pill, favoring a progesterone-only oral contraction or a progesterone-containing intrauterine device. She is ambulating independently and cleared for return to sport without any restrictions. The purpose of this case report is to present a case of a previously healthy adolescent who suffered from symptomatic bilateral PE without evidence of lower extremity deep venous thrombosis (DVT) following routine ACL reconstruction
Summary
Until further studies that examine complications associated with VTE prophylaxis become available, we do not recommend routine VTE prophylaxis for all patients having arthroscopic ACL reconstruction. JBM wrote the introduction, case presentation, conclusion, collected the figures, edited, and completed formatting. LP is the surgeon who was involved in the case, and is the main preceptor. She was involved in editing the final manuscript and getting patient consent. Author details 1Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Author details 1Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. 2College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada. 3Department of Surgery, Section of Orthopedic Surgery, University of Calgary, Calgary, AB, Canada. 4Department of Surgery, Division of Pediatric Orthopedic Surgery, Alberta Children’s Hospital, 2888 Shaganappi Trail NW, Calgary, AB T3B 6A8, Canada
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
