Immediate Pulmonary Embolism or Pulmonary Artery Thrombosis Following Blunt Chest Injury?

A pulmonary embolism usually appears as early as two to three days post-trauma, but in rare cases, it can manifest immediately. It may be a result of in situ thrombosis instead of dislodged deep vein thrombosis.

We present a 24-year-old patient involved in a motorcycle and car collision with blunt chest trauma, mild desaturation and a right clavicle fracture. A thorax computed tomography scan seven hours post-trauma revealed bilateral main pulmonary arteries thrombosis extending to the proximal segmental branches with no evidence of deep vein thrombosis or major thoracic injury. The patient was treated with low molecular weight heparin and discharged home after five days with a one-year follow-up.

This could be related to an inflammatory cascade secondary to the trauma which led to endothelial damage and formation of a de novo thrombus in the pulmonary vessels.

this case highlights the occurrence of immediate pulmonary embolism after minor blunt chest trauma in the absence of classical risk factors and has been treated successfully by low molecular weight heparin.

Pulmonary thrombosis may develop within hours of injury - even mild trauma and may occur de novo.Absence of risk factors (medical or traumatic) does not exclude pulmonary embolism or thrombosis.Despite major pulmonary vessel thrombosis, low molecular weight heparin can be used successfully.