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Updated: Aug 5, 2026
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A Porcine Model of Acute Autologous Pulmonary Embolism
Published on: September 6, 2024
Fatal Pulmonary Air Emboli Associated with Pneumatosis Intestinalis
Laura S Finn1,2, Brittany DePasquale1,2, Christine Camacho-Bydume3,4
1Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Summary
A child died suddenly after hematopoietic stem cell transplantation (HSCT) due to pulmonary air emboli. This rare complication stemmed from intestinal gas, highlighting the need for pathologists to consider air embolization in HSCT patients.
Area of Science:
- Medicine
- Pathology
- Hematology
Background:
- Hematopoietic stem cell transplantation (HSCT) is a life-saving procedure for genetic disorders like Hurler syndrome.
- Complications following HSCT can be diverse and sometimes unexpected.
- Pneumatosis intestinalis, gas in the bowel wall, is a rare but documented complication of HSCT.
Purpose of the Study:
- To report a rare cause of death following HSCT.
- To highlight the association between pneumatosis intestinalis and fatal air emboli.
- To emphasize the importance of considering iatrogenic air embolization in post-HSCT autopsies.
Main Methods:
- Case report of a 19-month-old patient who underwent HSCT for Hurler syndrome.
- Post-mortem examination to determine the cause of sudden death.
- Histopathological analysis to identify pulmonary air emboli and colonic pneumatosis intestinalis.
Main Results:
- The patient experienced sudden, unexpected death 11 months post-HSCT.
- Autopsy revealed pulmonary air emboli.
- The air emboli were linked to extensive colonic pneumatosis intestinalis.
Conclusions:
- Pneumatosis intestinalis, though rare, can lead to fatal air embolization after HSCT.
- Pathologists must maintain a high suspicion for air embolization as a cause of death in complex HSCT cases.
- Recognizing unusual HSCT complications is crucial for accurate autopsy diagnosis.
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