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[Pulmonary thromboembolism after chronic bladder distention].
M A Sousa Escandon1, M Alejandro, R Garcia Figueiras
1Servicio de Urologia, Hospital Comarcal de Monforte, 27400 Monforte de Lemos, Lugo, Espagne. a-sousa@yupimail.com
Summary
A chronic over-distended bladder caused a pulmonary embolism by obstructing iliac veins. This rare case highlights bladder distension as a potential cause of venous thromboembolism.
Area of Science:
- Urology
- Cardiology
- Radiology
Background:
- Chronic bladder over-distension can lead to pelvic venous compression.
- Iliac vein obstruction is a known complication of severe bladder distension.
Observation:
- A 73-year-old male presented with acute pulmonary embolism.
- Imaging revealed bilateral iliac vein obstruction and obstructive uropathy secondary to a massively over-distended bladder (2,300 cc urine).
Findings:
- Pulmonary embolism was confirmed via isotope lung scan.
- The patient improved with heparin anticoagulation and bladder catheterization, resolving edema and uropathy.
Implications:
- This case represents the first reported instance of pulmonary embolism stemming from a chronically over-distended bladder.
- Clinicians should consider bladder volume and pelvic venous stasis in patients with unexplained venous thromboembolism.