Catastrophic Pulmonary Embolism Despite Negative Ultrasonography for Deep Vein Thrombosis in the Patient after Posterior Thoracic Fusion Surgery

Catastrophic Pulmonary Embolism Despite Negative Ultrasonography for Deep Vein Thrombosis in the Patient after Posterior Thoracic Fusion Surgery

Fatal pulmonary embolism occurs in 0.1% to 0.26% of cases of spine fusion surgery. Early diagnosis of pulmonary embolism is difficult, and delay in treatment can lead to a fatal outcome. We report on a case of symptomatic pulmonary embolism which developed after induction of general anesthesia in a patient who had been immobile because of a previous spinal operation one week prior to this. Despite a negative preoperative ultrasound examination for deep vein thrombosis, the patient had developed a pulmonary embolism, which was diagnosed using intraoperative transesophageal echocardiography. Despite intensive cardiopulmonary resuscitation and thrombolytic therapy, the patient died within a few hours of diagnosis.