Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report
Keywords:
multidetector spiral CT scanning, pulmonary hypertension
Abstract
Pulmonary embolism (PE) is associated withconsiderable morbidity and mortality. Early
diagnosis and prompt treatment is essential, 1 • 2
however PE is rarely clinically diagnosed or
treated in children. Most clinically significant PE is not
recognized antemortem. 3Â While its diagnosis remains
a challenge as the signs and symptoms can often be
non-specific, an accurate diagnosis is essential for the
management of this disease. It is known that a number
of non-invasive diagnostic tools are available for its
detection nowadays. 1 • 2 .4 Even though multi-detector
spiral, also called helical, CT scanning is promising
and has been proven to be useful in diagnosing this
condition with high sensitivity and specificity, 5 it is
unavailable even in referral hospitals in Indonesia.
The gold standard, pulmonary angiography, is
considered as the procedure of choice to diagnose PE,
but unfortunately it is invasive. Failure to diagnose PE
accurately and promptly can result in excess morbidity
and death due to pulmonary hypertension (PH) and
recurrent venous thromboembolic events. Conversely,
unnecessary anticoagulation therapy poses a risk
without any benefit.2
References
1. Grandmaison, Lorin G, Durigon, Michel. Pulmonary
embolism: a rare cause of sudden infant death. Am J Forensic
Med Pathol. 2002;23(3):257-9.
2. Lingamanaicker J, Mukherjee JJ, Fock KM, Khoo TK. The
role of spiral computed tomogram in the diagnosis of acute
pulmonary embolism. Singapore Med J. 2001;42:455-9.
3. Donnerstein RL, Berg RA. Pulmonary embolism. In: Taussig
LM, Landau LI, editors. Pediatric respiratory medicine. St.
Louis: Mosby, 1999; p. 910-5.
4. Goldhaber SZ. Multislice computed tomography for
pulmonary embolism - A technological marvel. N Eng! J
Med. 2005;352: 1812-4.
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4th ed. St. Louis: Mosby. 2002.
58 • Paediatr Indones, Vol. 49, No. 1, January 2009
6. Rashid A, Ivy D. Severe paediatric pulmonary hypertension:
new management strategies. Arch Dis Child. 2005;90:9-8.
7. Carman TL, Deitcher SR. Advances in diagnosing and
excluding pulmonary embolism: spiral CT and D-dimer
measurement. Cleveland Clin J Med. 2002 ;69: 721-9.
8. Michelakis E, Tymchak, Lien D, Webster L, Hashimoto
K, Archer S. Oral sildenafil is an effective and specific
pulmonary vasodilator in patients with pulmonary arterial
hypertention. Circulation. 2002; 105:2398-400.
9. Vaughan OJ. Pulmonary infarction. [cited on 26 July 2005].
Available from: http: / /www.emedicine.com
10. Kohli A, Raj put D, Gomes M, Desai S. Imaging of pulmonary
thromboembolism. Ind J Radio! Image. 2002; 12:207-12.
11. Hartmann IJC, Hagen PJ, Melissant CF, Postmus PE, Prins
MH. Diagnosing acute pulmonary embolism. Am J Respir
Crit Care Med. 2000;162:2232-7.
12. Morris T. New options for pulmonary embolism diagnosis.
[cited on 30 July 2005]. Available from: http: // www.chrowrd/
news/pulm emb dx.doc
13. McLaughlin VV, Presberg KW, Doyle RL, Abman SH,
McCrory DC, Fortin T, et al. Prognosis of pulmonary arterial
hypertension. ACCP evidence-based clinical practice
guidelines. Chest. 2004;126:78S-92S.
14. Primary pulmonary hypertension. Cincinnati children's
[cited on 30 July 2005]. Available from: http://www.
cincinnatichildrens.org
15. Berger S. Pulmonary hypertension, primary. [cited on 27 May
2004]. Available from: http: / /www.emedicine.com
16. Andrews AH, Holtzmuller KC. Cardiac cirrhosis. [cited on
2 Sept 2004]. Available from: http: // www.emedicine.com / med !
topic275.htm.
embolism: a rare cause of sudden infant death. Am J Forensic
Med Pathol. 2002;23(3):257-9.
2. Lingamanaicker J, Mukherjee JJ, Fock KM, Khoo TK. The
role of spiral computed tomogram in the diagnosis of acute
pulmonary embolism. Singapore Med J. 2001;42:455-9.
3. Donnerstein RL, Berg RA. Pulmonary embolism. In: Taussig
LM, Landau LI, editors. Pediatric respiratory medicine. St.
Louis: Mosby, 1999; p. 910-5.
4. Goldhaber SZ. Multislice computed tomography for
pulmonary embolism - A technological marvel. N Eng! J
Med. 2005;352: 1812-4.
5. Park MK, Troxler RG. Pediatric cardiology for practitioners.
4th ed. St. Louis: Mosby. 2002.
58 • Paediatr Indones, Vol. 49, No. 1, January 2009
6. Rashid A, Ivy D. Severe paediatric pulmonary hypertension:
new management strategies. Arch Dis Child. 2005;90:9-8.
7. Carman TL, Deitcher SR. Advances in diagnosing and
excluding pulmonary embolism: spiral CT and D-dimer
measurement. Cleveland Clin J Med. 2002 ;69: 721-9.
8. Michelakis E, Tymchak, Lien D, Webster L, Hashimoto
K, Archer S. Oral sildenafil is an effective and specific
pulmonary vasodilator in patients with pulmonary arterial
hypertention. Circulation. 2002; 105:2398-400.
9. Vaughan OJ. Pulmonary infarction. [cited on 26 July 2005].
Available from: http: / /www.emedicine.com
10. Kohli A, Raj put D, Gomes M, Desai S. Imaging of pulmonary
thromboembolism. Ind J Radio! Image. 2002; 12:207-12.
11. Hartmann IJC, Hagen PJ, Melissant CF, Postmus PE, Prins
MH. Diagnosing acute pulmonary embolism. Am J Respir
Crit Care Med. 2000;162:2232-7.
12. Morris T. New options for pulmonary embolism diagnosis.
[cited on 30 July 2005]. Available from: http: // www.chrowrd/
news/pulm emb dx.doc
13. McLaughlin VV, Presberg KW, Doyle RL, Abman SH,
McCrory DC, Fortin T, et al. Prognosis of pulmonary arterial
hypertension. ACCP evidence-based clinical practice
guidelines. Chest. 2004;126:78S-92S.
14. Primary pulmonary hypertension. Cincinnati children's
[cited on 30 July 2005]. Available from: http://www.
cincinnatichildrens.org
15. Berger S. Pulmonary hypertension, primary. [cited on 27 May
2004]. Available from: http: / /www.emedicine.com
16. Andrews AH, Holtzmuller KC. Cardiac cirrhosis. [cited on
2 Sept 2004]. Available from: http: // www.emedicine.com / med !
topic275.htm.
Published
2009-03-01
How to Cite
1.
Nataprawira H, Rahayuningsih S, Afandi N, Firman A, Koan T. Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report. PI [Internet]. 1Mar.2009 [cited 26Apr.2024];49(1):54-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/456
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Received 2016-09-05
Accepted 2016-09-05
Published 2009-03-01
Accepted 2016-09-05
Published 2009-03-01
