Death due to early pulmonary thromboembolism following tibial fracture: A case report

Abstract

Pulmonary Thrombo Embolism (PTE) is primarily attributed to venous thromboembolism, resulting in the obstruction of pulmonary arteries by a thrombus that impedes blood flow to the lungs. The thrombus typically gets lodged at the bifurcation of the main pulmonary artery or the lobar branches, leading to hemodynamic compromise. While the origin of the thrombus is commonly traced back to the lower extremities (Deep Vein Thrombosis, DVT), in rare instances, it may arise from the pelvis, renal veins, upper extremity veins, or right side of the heart. Various factors can contribute to the development of deep vein thrombosis, but in the context of long bone fractures, it is predominantly associated with prolonged immobilization. The typical time frame for DVT to manifest after the injury is 7 to 10 days. However, there have been infrequent cases where PTE has developed within 72 hours of the injury. Several theories have been proposed to elucidate the early onset of PTE in such cases.This report presents a case of early pulmonary thromboembolism in a tibial fracture, as observed during the autopsy examination of a 22-year-old male who succumbed to injuries sustained in a road traffic accident within 6 hours of the incident. Subsequent histopathological analysis following the autopsy revealed the presence of a thrombus in the pulmonary artery.