Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report

Abstract

Pulmonary embolism (PE) is associated with considerable 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. 3 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

Keywords

• multidetector spiral CT scanning
• pulmonary hypertension