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

• Published in: The journal of spinal cord medicine Vol. 35; no. 3; pp. 178 - 181
• Main Authors: Han, Jae-Young, Seon, Hyo-Jeong, Choi, In-Sung, Ahn, Youngkeun, Jeong, Myung-Ho, Lee, Sam-Gyu
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.05.2012; Maney Publishing
• Subjects: Adult; Anticoagulant therapy; Hemopericardium; Humans; Male; Paraplegia; Paraplegia - complications; Paraplegia - diagnostic imaging; Pericardial Effusion - complications; Pericardial Effusion - diagnostic imaging; Pulmonary Embolism - complications; Pulmonary Embolism - diagnostic imaging; Pulmonary thromboembolism; Radiography; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - diagnostic imaging; Thoracic Vertebrae - diagnostic imaging
• ISSN: 1079-0268; 2045-7723
• DOI: 10.1179/2045772312Y.0000000010

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.