Pulmonary embolism of haemostatic material during paediatric neurosurgery

A 7-year-old boy with juvenile pilocytic astrocytoma experienced sudden haemodynamic collapse after significant venous bleeding and the application of absorbable haemostatic gelatin sponge. Following successful resuscitation, intra-operative transthoracic echocardiography revealed acute right ventricular failure. Subsequent computed tomography angiography confirmed the diagnosis of a massive pulmonary embolism. Extracorporeal membrane oxygenation was initiated and catheter thrombectomy was performed. The patient had a rapid and complete recovery. This case underscores the importance of vigilance and multidisciplinary teamwork in the management of rare but life-threatening complications.