Extensive Bilateral Pulmonary Embolism Without Deep Vein Thrombosis After Varicose Vein Stripping: Superficial Venous Thrombosis as a Potential Source

Pulmonary embolism (PE) is a common and potentially life-threatening condition, most often arising from deep vein thrombosis (DVT). However, PE may rarely occur without demonstrable DVT, including after superficial venous procedures. We present the case of a 49-year-old morbidly obese woman with a recent history of right lower-extremity varicose vein stripping who presented with worsening shortness of breath. Imaging revealed a large burden of bilateral pulmonary emboli involving all lobar arteries. Duplex USG showed no evidence of DVT but demonstrated significant superficial venous thrombosis (SVT) in the great saphenous vein, with associated thrombus and hematoma. The patient remained hemodynamically stable and was managed with anticoagulation therapy. This case highlights SVT as a potential source of PE, particularly in the presence of additional risk factors such as obesity, recent surgery, and decreased mobility.