Pulmonary Embolism after Relief of Urinary Obstruction.

A 77-year-old woman with a history of type 2 diabetes mellitus and complete remission of minimal-change disease who was consuming 5 mg prednisolone with normal serum creatinine and albumin levels presented with abdominal pain that had started the previous day. A physical examination revealed a distended mid-lower abdomen and bilateral pitting edema. Computed tomography (CT) showed a dilated bladder and collapsed inferior vena cava (Picture 1). We diagnosed her with urinary obstruction caused by diabetic neurogenic bladder and inserted a urinary catheter. At 22 hours after catheterization, 3,700 mL of urine was collected, and at 23 hours, her systolic blood pressure decreased from 100 to 80 mmHg. Contrast-enhanced CT showed a pulmonary embolism (PE) (Picture 2) and deep vein thrombosis (DVT) of the left popliteal fossa. Systemic anticoagulation therapy was administered. DVT complications after urinary obstruction are rare (1,2). This is a rare case of PE occurring after urinary obstruction relief. Patients with a severely dilated bladder should be investigated for DVT and PE.

Picture 1.

Picture 2.

The authors state that they have no Conflict of Interest (COI).