Successful systemic thrombolysis in high-risk pulmonary thromboembolism after inguinal hernia repair surgery. Case report.

Trombólisis sistémica exitosa en el tromboembolismo pulmonar de alto riesgo tras cirugía de reparación de hernia inguinal. A propósito de un caso

Massive pulmonary thromboembolism is a potentially fatal entity if it is not treated immediately. Systemic thrombolysis is an adequate therapy for these cases when they present with data of obstructive shock or severe acute respiratory failure. We present the case of a 69-year-old man with a history of scheduled inguinal hernia repair ten days before the event who attended the Emergency Department due to syncope. Four hours into his hospital stay, he suffered hypotension and sudden desaturation and diagnosed with massive pulmonary thromboembolism requiring the administration of fibrinolytic drugs. In this case, there were no hemorrhagic adverse events and reperfusion was complete at once after its administration. Electrocardiogram (EKG) and computed tomography (CT) images with contrast before and after the administration of the fibrinolytic are attached, showing total reperfusion of the pulmonary artery and correction of all electrical changes secondary to right ventricular overload in less than 24 hours. The patient was discharged to Internal Medicine at 72 hours.