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J Korean Soc Emerg Med > Volume 28(6); 2017 > Article
Journal of The Korean Society of Emergency Medicine 2017;28(6): 676-681.
Acute Pulmonary Embolism Associated with Transposition of the Inferior Vena Cava in a 14-year-old Boy
Hyuck-Jin Kwon1, Jin-Shik Shin1, Hyun-Sook Kim2, Kwanseop Lee3, Sung Hye Kim1*
1Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, Korea
2Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
3Department of Radiology, Hallym University Sacred Heart Hospital, Anyang, Korea
Correspondence  Sung Hye Kim ,Tel: 031-380-3730, Fax: 031-380-1900, Email: Rohetkim@yahoo.co.kr,
Received: July 27, 2017; Revised: July 31, 2017   Accepted: October 4, 2017.  Published online: December 31, 2017.
ABSTRACT
Idiopathic venous thromboembolism (VTE) and pulmonary embolism (PE) are relatively infrequent in the pediatric population but are almost always associated with an underlying disease or risk factors, such as congenital or acquired coagulation abnormalities, autoimmune disorders, or malignancies. In the pediatric emergency department, VTE, and particularly, PE, are often less considered in differential diagnoses because of their low incidence. On the other hand, a delayed diagnosis can result in serious morbidity and mortality. Therefore, even if there are no well-known risk factors, it is important to consider the possibility of PE, whenever there are suspicious symptoms and signs. The transposition of the inferior vena cava (IVC) is one of the major anatomical variants among the spectrum of IVC malformations. Although most IVC malformations are clinically silent and are discovered incidentally on radiographs, they are associated with PE in rare cases. In the pediatric population, no cases of transposition of the IVC that was discovered by acute PE have been reported. We report a case of acute PE associated with a transposition of the IVC in a 14-year-old boy without intra-cardiac anomalies or coagulation abnormalities.
Key words: Vena cava, Inferior, Pulmonary embolism, Vascular malformations, Congenital, Venous thromboembolism
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