Imagen clínica
Embolismo pulmonar por cuerpo extraño
Foreign-Body Pulmonary Embolism
Aaron Cordova, Inmaculada Alfageme
Corresponding author
Unidad de Gestión Clínica de Neumología, Hospital Universitario Virgen de Valme, Sevilla, España
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A propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "120" "paginaFinal" => "122" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pulmonary Embolism and Concomitant Paradoxical Embolism. A Case Report" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1045 "Ancho" => 1500 "Tamanyo" => 151964 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Imagen obtenida mediante angio-TAC de tórax. 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Refería disnea de grandes esfuerzos de 4<span class="elsevierStyleHsp" style=""></span>años de evolución, episodios de opresión torácica y palpitaciones. Exploración física normal. En la TAC, imágenes de cuerpo extraño con densidad calcio en la arteria pulmonar izquierda y similares de menor tamaño en el hemitórax derecho. A nivel de cuerpo vertebral L5, fuga de cemento vertebral comunicándose con la vena iliaca común izquierda.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Se diagnosticó embolismo pulmonar (EP) por polimetilmetacrilato (PMMA), material utilizado como cemento en la vertebroplastia. La fuga del cemento a los tejidos periféricos durante el procedimiento es la complicación más frecuente. El EP se produce del 3,4 al 23% en los casos de vertebroplastia por fracturas osteoporóticas<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>, y suele ser asintomático en la mayoría de los casos. El manejo del EP postoperatorio inmediato se basa en la presencia de síntomas y la localización del émbolo, recomendándose observación en los casos asintomáticos, anticoagulación de 3 a 6<span class="elsevierStyleHsp" style=""></span>meses en los sintomáticos o con émbolos centrales, y cirugía en los casos más graves.</p><p id="par0015" class="elsevierStylePara elsevierViewall">En nuestro caso, se decidió no tratar por la antigüedad del procedimiento y revisar periódicamente, no habiendo presentado cambios clínicos en 3<span class="elsevierStyleHsp" style=""></span>años de seguimiento.</p><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleInlineFigure"><elsevierMultimedia class="elsevierStyleLink" ident="fx1"></elsevierMultimedia></span></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:1 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of pulmonary cement embolism after percutaneous vertebroplasty and kyphoplasty: A systematic review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Krueger" 1 => "C. Bliemel" 2 => "R. Zettl" 3 => "S. 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