Transesophageal Echocardiographic Diagnosis of Pulmonary Thromboembolism during Cesarean Delivery: A case report.

Oh,  Choong Sik; Kwak,  Sang Won; Kim,  Tae Yop; Woo,  Nam Sik; Sohn,  In Sook; Chee,  Hyun Keun

doi:2008.54.1.117

Case Report

Korean Journal of Anesthesiology 2008;54(1):117-122.
DOI: https://doi.org/10.4097/kjae.2008.54.1.117

Transesophageal Echocardiographic Diagnosis of Pulmonary Thromboembolism during Cesarean Delivery: A case report.

Choong Sik Oh, Sang Won Kwak, Tae Yop Kim, Nam Sik Woo, In Sook Sohn, Hyun Keun Chee

¹Department of Anesthesiology and Pain Medicine, Gangneung Asan Hospital, Ulsan University School of Medicine, Gangneung, Korea. taeyop@kuh.ac.kr
²Department of Anesthesiology and Pain Medicine, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea.
³Department of Obstetrics and Gynecology, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea.
⁴Department of Chest Surgery, Konkuk University Hospital, Konkuk University School of Medicine, Seoul, Korea.

Abstract

Acute pulmonary thromboembolism (PTE) is life-threatening and difficult to diagnose. However, echocardiography can help diagnose and monitor PTE by visualizing the thrombus and assessing hemodynamic changes. Here we report the usefulness of transesophageal echocardiography (TEE) in a diagnosis of maternal PTE during cesarean delivery by showing a thromboembolus in pulmonary artery. In addition, TEE also prompted effective cardiopulmonary resuscitation for recurrent hemodynamic collapse due to a massive PTE, as well as rapid introduction of an extracorporeal membrane oxygenator to treat maternal hypoxia.

Key Words: cesarean delivery; pulmonary thromboembolism; transesophageal echocardiography