Case Report (n=1)
Successful management of perioperative pulmonary embolism with streptokinase in a patient undergoing spinal surgery, despite surgical site bleeding requiring transfusions.
May warrant consideration in select perioperative PE after spinal surgery; extends limited evidence but should not yet change practice.
Acute pulmonary embolism (PE) is a relatively common complication after major orthopedic surgeries with a high mortality rate. We present a case of L4–L5 disc prolapse with radiculopathy posted for spinal instrumentation and fusion surgery who developed PE perioperatively. It was diagnosed initially with point-of-care echocardiography and confirmed with computed tomography pulmonary angiography. The patient was thrombolyzed with streptokinase, following which she developed bleeding from the surgical site which was managed conservatively with blood transfusions. The patient recovered well and discharged after a week. The management of PE tests the skills of the anesthetist with respect to detection and rapid hemodynamic management.
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Segaran et al. (2018) conducted a case report in Perioperative pulmonary embolism (n=1). Streptokinase thrombolysis was evaluated on Recovery and discharge.
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