Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report

Abstract

Pulmonary embolism (PE)  is  associated withconsiderable morbidity and mortality. Earlydiagnosis and prompt treatment  is  essential,  1 • 2however PE  is  rarely clinically diagnosed ortreated in children. Most clinically significant  PE  is  notrecognized antemortem. 3  While its diagnosis remainsa challenge  as  the signs and symptoms  can  often benon-specific,  an  accurate diagnosis  is  essential for themanagement  of  this disease. It  is  known  that  a numberof  non-invasive diagnostic tools are available for itsdetection nowadays. 1 • 2 .4  Even though multi-detectorspiral, also called helical,  CT  scanning  is  promisingand has  been  proven to be useful  in  diagnosing thiscondition with high sensitivity  and  specificity, 5  it  isunavailable even  in  referral hospitals  in  Indonesia.The  gold  standard,  pulmonary  angiography,  isconsidered  as  the procedure of choice to diagnose PE,but  unfortunately it  is  invasive. Failure to diagnose PEaccurately and promptly  can  result in excess morbidityand  death  due to pulmonary hypertension (PH) andrecurrent venous thromboembolic events. Conversely,unnecessary  anticoagulation  therapy poses a riskwithout any benefit.2