E. Ippolito, A. Buora, G. Belcaro
Dec 1, 2012
A 51 year old woman was admitted for night dyspneic attacks and fainting. When hospitalised the patient reported in the previous 10 days dry cough, edema and pain (left leg). The woman's medical history did not show any risk factors for vein thromboembolism, d-dimer dosage appeared increased and arterial blood gas showed hypoxemia and hypocapnia. ECG and chest X-Rays were within normal limits; a chest CT diagnosed pulmonary embolism that was treated with thrombolytic therapy. Venous lower extremity ultrasound detected ilio-femoral and popliteal venous thrombosis and an abdominal CT showed a swollen and fibromatous uterus, obstructing the left iliac vein system. Thrombolytic therapy was effective to for pulmonary embolism and to begin recanalization of the iliac, femoral, and popliteal veins. The patients was sent home in good clinical conditions, with anticoagulant therapy; later the uterine fibroma was treated with hysterectomy.