Simultaneously diagnosed pulmonary thromboembolism and hemopericardium in a man with thoracic spinal cord injury

Authors: Han, Jae-Young; Seon, Hyo-Jeong; Choi, In-Sung; Ahn, Youngkeun; Jeong, Myung-Ho; Lee, Sam-Gyu

Source: Journal of Spinal Cord Medicine, Volume 35, Number 3, May 2012 , pp. 178-181(4)

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Abstract:

Background:

Simultaneous pulmonary thromboembolism (PTE) and hemopericardium is a rare but life-threatening condition. As hemopericardium is a contraindication to anticoagulation treatment, it is challenging to handle both conditions together.

Objective:

The objective of the study was to report a rare case of a man with thoracic spinal cord injury presenting with simultaneous PTE and hemopericardium.

Design:

Case report.

Subject:

A 43-year-old man with incomplete T9 paraplegia (American Spinal Injury Association Impairment Scale D) complained of fever one and a half months after spinal cord injury sustained in a fall.

Findings:

During evaluation of fever origin, chest computed tomography and transthoracic echocardiogram revealed simultaneous PTE and hemopericardium. After serial echocardiograms over 2 days demonstrated stability, intravenous heparin, and oral warfarin were administered and his medical status was observed closely. Ultimately, both conditions improved without significant complications.

Conclusion:

We report successful treatment of man with acute spinal cord injury who presented with simultaneously diagnosed PTE and hemopericardium, a rare complication involving two distinct and opposing pathological mechanisms and conflicting treatments.

Keywords: Pulmonary thromboembolism; Hemopericardium; Spinal cord injuries; Paraplegia; Anticoagulant therapy

Document Type: Research Article

DOI: http://dx.doi.org/10.1179/2045772312Y.0000000010

Affiliations: Chonnam National University Medical School & Hospital, Gwangju City, Republic of Korea

Publication date: 2012-05-01

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