Zuzana Mináriková, Jozef Kalužay, Veronika Pokorná, Oľga Jurkovičová
In the present case report the authors describe a case of pulmonary embolism in a young obese man that emerged after
appendectomy due to phlegmonous appendicitis complicated by wound infection with secondary healing and septicemia.
Based on the case report the authors point out the difficulties in recognising postoperative pulmonary embolism.
Its identification may be further aggravated if it manifests with atypical clinical symptomatology, such as abdominal
pain and fever in the case of our patient. Incidental finding of consolidation changes and dystelectases in dorsobasal
lungs with small pleural effusion on the right, which was found in abdominal CT, drew attention to the possibility of
pulmonary embolism, although initially we assumed inflammatory aetiology of this finding. Correctly indicated CT pulmonary
angiography finally confirmed pulmonary embolism as the cause of the patient’s symptoms. Since pulmonary
embolism in the patient developed despite adequate thromboprophylaxis made in accordance with standard procedures,
the authors raise the question of the need for individual adaptation of the standard protocol of prophylaxis of venous
thromboembolism.