title: Pulmonary embolism associated with spontaneous bilateral Achilles tendon rupture.
abstract: Bilateral Achillies tendon ruptures are a rare occurrence that usually occur in patients with chronic systemic disease. Many cases are also associated with corticosteroid or fluoroquinolone use. Nonoperative treatment is generally indicated in this patient population, as the patients are often considered poor surgical candidates. Nonoperative immobilization, however, conveys the risk of developing deep venous thrombosis and pulmonary embolism. Such risks are even greater in patients displaying bilateral Achilles tendon ruptures. In this report, we illustrate the case of a near-fatal pulmonary embolism as associated with bilateral spontaneous Achilles tendon ruptures. We also review the current literature and make recommendations for prophylaxis and treatment of these potentially devastating complications.
authors.affiliation: Harvard Medical School, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA. miguel_ramirez@hms.harvard.edu
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Ramirez
authors.forename: Lars C
authors.initials: LC
authors.lastname: Richardson
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects; D024841:Fluoroquinolones / Q000009:adverse effects; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D008297:Male; D011655:Pulmonary Embolism / Q000209:etiology*; D012422:Rupture, Spontaneous / Q000139:chemically induced / Q000150:complications; D020246:Venous Thrombosis / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D000890:Anti-Infective Agents; D024841:Fluoroquinolones