A High Index of Clinical Suspicion, Empirical Administration of Unfractionated Heparin and an Effective CPR - Key to a Successful Outcome in Intra-Operative Pulmonary Embolism

Husain F, Sharma P, Arya M and Dali JS

Published on: 2023-10-20


Intraoperative pulmonary thromboembolism (PTE) is a relatively uncommon entity with a reported incidence of approximately 4.1% in gynaecological abdominal surgery for malignancy and 0.4% for non-abdominal surgeries (orthopaedic procedures) [1].

Pulmonary embolism occurs in approximately 0.3% to 1.6% of the surgical population [2]. Such cases Usually go undiagnosed and are rarely reported in literature. Massive PTE can cause sudden intra-operative cardiovascular collapse [3,4] causing death in 50% patients within 15 minutes and only 33% surviving over the next 2 hours [5] .

We report such a case where a high index of clinical suspicion and empirical administration of unfractionated heparin on table along with early and effective CPR revived our patient. The etiopathogenesis of embolism in our case may be related to secondary pulmonary ascariaisis as evident by presence of ascaris in expectoration on the third post-operative day.