Diffuse fatal pulmonary microembolism of retroperitoneal extravascular origin.
A 34-year-old woman who had type I diabetes mellitus for 22 years and chronic renal failure for 2 years underwent a combined kidney and pancreas transplantation. Her uremia and insulin-dependence disappeared thereafter. However, she suddenly developed acute respiratory distress and died 22 days after the surgery. Diffuse pulmonary microemboli composed of necrotic tissue debris, fat cells, and muscle fragments were found. The source of the emboli was apparently a localized liquefying hematoma with necrotic muscle and fat in the left retroperitoneal space. Although such an occurrence seems to be extremely rare, the present case demonstrates that a liquefying hematoma with necrotic tissue in a confined space may indeed give rise to fatal pulmonary microembolism.
Ho
K J
KJ
Department of Pathology, University of Alabama, Birmingham.
D000328:Adult; D005260:Female; D006406:Hematoma / Q000150:complications*; D006801:Humans; D016030:Kidney Transplantation; D016035:Pancreas Transplantation; D011183:Postoperative Complications; D011655:Pulmonary Embolism / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D012187:Retroperitoneal Space / Q000098:blood supply