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[Pelvic phlebitis presenting as paradoxical arterial embolism]
M A Pistorius1, D Elkouri, P de Faucal
1Service de Médecine Interne, Hôtel-Dieu, Nantes.
Journal Des Maladies Vasculaires
|January 1, 1994
Summary
A young woman experienced paradoxical embolism in her right arm after childbirth. Pelvic vein thrombosis was identified as the source using advanced imaging techniques and radiolabeled antifibrin antibody scintigraphy.
Area of Science:
- Cardiology
- Vascular Surgery
- Radiology
Background:
- Paradoxical embolism is a rare condition where a clot travels from the venous to the arterial system, often through a right-to-left shunt like a patent foramen ovale.
- Postpartum complications can increase the risk of venous thromboembolism.
Observation:
- A 24-year-old woman presented with arterial ischemic symptoms in her right arm following childbirth.
- Diagnostic evaluations including right cardiac catheterization and contrast echocardiography confirmed a patent foramen ovale.
- Clinical, immunoscintigraphic, and radiologic data strongly suggested the pelvic region as the origin of the embolic material.
Findings:
- The case highlights the successful diagnosis of a pelvic-origin embolic event causing arterial ischemia.
- Scintigraphy utilizing radiolabeled antifibrin antibody proved instrumental in identifying the embolic source in the pelvic region.
- This imaging modality allowed for precise localization of the thrombus, distinguishing it from other potential sources.
Implications:
- This case underscores the importance of considering paradoxical embolism in young women with unexplained arterial ischemia, especially postpartum.
- Radiolabeled antifibrin antibody scintigraphy offers a valuable tool for pinpointing the venous source of paradoxical emboli.
- Early and accurate diagnosis of the embolic origin is crucial for appropriate management and prevention of recurrent events.