Key result
A 16-year-old girl developed a rare symptomatic bilateral pulmonary embolism without deep vein thrombosis six days after routine arthroscopic anterior cruciate ligament reconstruction.
Case Report (n=1)
No
Symptomatic bilateral pulmonary embolism can occur in healthy adolescents following routine arthroscopic knee surgery and can be successfully managed with anticoagulation.
Rare bilateral PE without DVT may occur after routine knee arthroscopy in adolescents; hypothesis-generating and should not change practice.
BACKGROUND: Venous 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 PRESENTATION: A 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. CONCLUSIONS: Symptomatic 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.
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Bourget-Murray et al. (2018) conducted a case report in Pulmonary embolism following arthroscopic anterior cruciate ligament reconstruction (n=1). Arthroscopic anterior cruciate ligament reconstruction was evaluated on Symptomatic bilateral pulmonary embolism. A 16-year-old girl developed a rare symptomatic bilateral pulmonary embolism without deep vein thrombosis six days after routine arthroscopic anterior cruciate ligament reconstruction.
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