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17.03.2023 | Case Report

Fecal pulmonary embolism: a case report and literature review

verfasst von: Pablo Santiago Díaz, Javier Gimeno Beltrán, Joan Lop Gros, Diego Tuñas Solà, Gina María Parini Trapani, Blanca Montcusí Ventura, Ana Arias López, Belén Lloveras Rubio

Erschienen in: Forensic Science, Medicine and Pathology | Ausgabe 2/2024

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Abstract

Pulmonary embolism (PE) is a common cause of death in hospitalized patients. These emboli are usually related to deep venous thrombosis, but other etiologic factors may be the cause. A 60-year-old male was diagnosed with rectal adenocarcinoma and treated by surgical rectal resection. After surgery, he presented with a decreased level of consciousness and hypoxia with no signs of bleeding. PE was ruled out by pulmonary angiography. Given the hemodynamic instability, contrast-enhanced CT was performed, showing a discrete leak related to the rectal anastomosis, which required urgent surgery. The patient suffered cardiorespiratory arrest prior to surgery, and once resolved, the surgical procedure was limited to disconnecting the intestinal anastomosis, leaving the colon and rectal stumps free in the abdomen and keeping the abdominal cavity open with negative-pressure therapy. The patient suffered from another cardiorespiratory arrest after surgery, with abdominal distension and serous-hemorrhagic material discharge through the negative-pressure device. On a new surgical revision, no bleeding was identified, so the symptoms were attributed to coagulopathy. The patient died and autopsy was performed. The autopsy revealed no surgery-related complications. The lungs were increased in weight and showed a normal macroscopic appearance; in contrast, the histological study revealed multiple and bilateral thrombo-embolisms affecting small distal arteries. Those thrombi were composed of intestinal contents, including vegetal particles, mucinous and biliary material, fibrin, and bacterial structures. Fecal PE is an extremely infrequent event. Isolated cases have been described in association with communications between the digestive tract lumen and the systemic circulation, with a generally fatal prognosis.
Literatur
10.
Zurück zum Zitat Vance G. Vegetable embolization of the pulmonary arteries. Arch Pathol (Chic). 1961;71:621–8. Vance G. Vegetable embolization of the pulmonary arteries. Arch Pathol (Chic). 1961;71:621–8.
11.
Zurück zum Zitat Itabashi HH, Granada LO. Cerebral food embolism secondary to esophageal-cardiac perforation. J Am Med Assoc. 1972;219(3):373–5.CrossRef Itabashi HH, Granada LO. Cerebral food embolism secondary to esophageal-cardiac perforation. J Am Med Assoc. 1972;219(3):373–5.CrossRef
12.
Zurück zum Zitat Mott LJM, Austin GE. Cerebral embolization resulting from esophageal-atrial fistula. Arch Intern Med. 1976;136:718–20.CrossRefPubMed Mott LJM, Austin GE. Cerebral embolization resulting from esophageal-atrial fistula. Arch Intern Med. 1976;136:718–20.CrossRefPubMed
13.
Zurück zum Zitat Smith RRL, Hutchins GM. Pulmonary fecal embolization complicating the Budd-Chiari syndrome. N Engl J Med. 1978;298(18):1069–70.CrossRefPubMed Smith RRL, Hutchins GM. Pulmonary fecal embolization complicating the Budd-Chiari syndrome. N Engl J Med. 1978;298(18):1069–70.CrossRefPubMed
14.
Zurück zum Zitat Godwin TA, Mercer G, Holodny AL. Fatal embolization of intestinal contents through a duodenocaval fistula. Arch Pathol Lab Med. 1991;115:93–5.PubMed Godwin TA, Mercer G, Holodny AL. Fatal embolization of intestinal contents through a duodenocaval fistula. Arch Pathol Lab Med. 1991;115:93–5.PubMed
15.
Zurück zum Zitat Reynolds P, Walker FO, Eades J, Smith JD, Lantz PE. Food embolus. Journal of Neurological Sciences. 1997;149:185–90.CrossRef Reynolds P, Walker FO, Eades J, Smith JD, Lantz PE. Food embolus. Journal of Neurological Sciences. 1997;149:185–90.CrossRef
Metadaten
Titel
Fecal pulmonary embolism: a case report and literature review
verfasst von
Pablo Santiago Díaz
Javier Gimeno Beltrán
Joan Lop Gros
Diego Tuñas Solà
Gina María Parini Trapani
Blanca Montcusí Ventura
Ana Arias López
Belén Lloveras Rubio
Publikationsdatum
17.03.2023
Verlag
Springer US
Erschienen in
Forensic Science, Medicine and Pathology / Ausgabe 2/2024
Print ISSN: 1547-769X
Elektronische ISSN: 1556-2891
DOI
https://doi.org/10.1007/s12024-023-00615-4

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