Case of intersurgical acute massive pulmonary embolism with successful thrombolysis therapy

A 56-year-old man underwent surgery to repair an open left tibial fracture. At the end of the surgery, he exhibited haemodynamic instability requiring an increased epinephrine dose. The situation was life-threatening, and the patient was at risk for pulmonary thromboembolism. Although surgery is a contraindication to thrombolysis, we performed intravenous thrombolysis with alteplase and used a femoral tourniquet to decrease blood loss. Once the patient was haemodynamically stable, he was taken to the intensive care unit. The patient recovered and was discharged with a long-term anticoagulation plan. In conclusion, thrombolysis can successfully treat life-threatening pulmonary thromboembolism during the early postoperative period.