Incidental Finding of Saddle Pulmonary Embolism on a CT Scan of the Abdomen and Pelvis in a Patient With Adenocarcinoma of the Colon

Nahidi, Seyed Mohammad; Ali, Uzayr; Duka, Leonidha; Fuentes-Rosales, Juan C; Bhatt, Utpal

doi:10.7759/cureus.20757

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Nonetheless, we believe that this is an original finding in patients with cancer that emphasizes the clinical-radiological dissociation previously described in isolated case reports. 36,37 Notably, patients with saddle PE in our study more frequently had signs of RV overload compared with nonsaddle PE, in line with the study by Kwak et al 35 In contrast, in a retrospective study of 52 patients with cancer and central acute symptomatic PE with thorough revision of CT scans, Yusuf et al 38 did not find differences in signs of RV overload according to saddle versus nonsaddle central PE. Despite having found significant differences in PE presentation and signs of RV overload in our study, we could not demonstrate a worse overall or PE-related 30-day mortality according to saddle versus nonsaddle PE.…”

Section: Discussionsupporting

confidence: 90%

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Diagnosis of Bleeding Disorders in Adolescents Hospitalized for Heavy Menstrual Bleeding

Amos

Sherman

Carpenter

2022

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Hundreds of adolescents are hospitalized in the United States yearly with anemia due to heavy menstrual bleeding (HMB). Limited data exist regarding how these patients are evaluated and how many are diagnosed with a bleeding disorder. The aim of this study was to determine the prevalence of bleeding disorders in adolescents hospitalized for HMB. Secondary aims included identification of risk factors for severe anemia leading to hospitalization and the hematology assessment. This was a retrospective cohort study of patients aged 9 to 21 years hospitalized for HMB and anemia at a tertiary care children's hospital from January 1, 2000, to December 31, 2017. A total of 118 girls hospitalized for HMB and anemia were included. Almost 30% of patients were African American. Hematology involvement did not occur in 42% of patients. Sixty patients completed bleeding disorder testing and 57% (34/60) were diagnosed with a bleeding disorder. Most patients diagnosed with von Willebrand disease (VWD) tested while hospitalized and anemic had VW levels <100%A but 9/25 (36%) girls not evaluated by Hematology also had VW levels <100%. Despite an established Inpatient Coagulation Consult service, many adolescents hospitalized with HMB did not receive an appropriate evaluation for bleeding disorders. African Americans were disproportionately hospitalized for HMB. VW levels are elevated with HMB and severe anemia, but levels <100 seem to be predictive of VWD in this setting. Further research is needed to determine optimal timing of bleeding disorder evaluation, but many adolescents hospitalized for HMB may have an underlying bleeding disorder.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Diagnosis of Bleeding Disorders in Adolescents Hospitalized for Heavy Menstrual Bleeding

Amos

Sherman

Carpenter

2022

TH Open

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Saddle Pulmonary Embolism in Patients with Cancer in the Era of Incidental Events: Clinical Findings and Outcomes in a Single Centre Cohort

Aramberri

Benegas

Sánchez

et al. 2022

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Background There is scarce information regarding the prevalence and clinical impact of saddle pulmonary embolism (PE) in patients with cancer. Objectives This study aimed to assess the prevalence, clinical findings, and short-term outcomes of patients with cancer-related saddle PE including acute symptomatic and unsuspected events. Patients/Methods Consecutive patients with cancer-related PE (March 1, 2006–October 31, 2014) were retrospectively reviewed by a chest radiologist to assess PE burden and signs of right ventricular (RV) overload. The clinical outcomes within 30 days were evaluated according to saddle versus nonsaddle PE. Results Thirty-six (12%) out of 289 patients with newly diagnosed cancer-related PE presented with saddle PE. Saddle PE was found in 21 cases (58%) with acute symptomatic PE and the remaining 15 cases (42%) were found as unsuspected findings. Patients with saddle PE had more frequently experienced a previous thrombotic event (31 vs. 13%; p=0.008), and it occurred more frequently as an acute symptomatic event (58 vs. 39%; p=0.025) compared with those with nonsaddle PE. Signs of RV overload including RV/left ventricle ratio ≥1 (22 vs. 4%; p<0.001) and interventricular septum displacement (53 vs. 20%; p<0.001) were also more common in patients with saddle PE compared with nonsaddle PE. Overall, PE-related mortality, venous thromboembolism recurrence, and major bleeding within 30 days were found to be similar according to saddle versus nonsaddle PE. Conclusion Saddle PE is not uncommon in patients with cancer-related PE including in those with unsuspected PE. Similar 30-day outcomes were found according to saddle versus nonsaddle PE in our cohort.

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Saddle pulmonary embolus

Dzamatira¹

2022

Radiopaedia.org

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Incidental Finding of Saddle Pulmonary Embolism on a CT Scan of the Abdomen and Pelvis in a Patient With Adenocarcinoma of the Colon

Cited by 3 publications

References 17 publications

Diagnosis of Bleeding Disorders in Adolescents Hospitalized for Heavy Menstrual Bleeding

Diagnosis of Bleeding Disorders in Adolescents Hospitalized for Heavy Menstrual Bleeding

Saddle Pulmonary Embolism in Patients with Cancer in the Era of Incidental Events: Clinical Findings and Outcomes in a Single Centre Cohort

Saddle pulmonary embolus

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