Abdominal manifestations of pulmonary embolism

The cardiopulmonary manifestations of acute pulmonary embolism are well known. However, abdominal manifestations of thromboembolic disease are less well appreciated. We recently encountered three patients with pulmonary emboli who also had complications of abdominal signs and symptoms. Two patients initially had abdominal complaints that obscured the diagnosis. In the other patient, symptoms and signs developed that were indistinguishable from an acute surgical condition of the abdomen after the diagnosis of massive pulmonary embolism was established. Abdominal manifestations alone may be the presenting features of pulmonary embolism or may complicate the clinical course.