Perioperative Diagnosis of Acute Pulmonary Embolism Following Laparoscopic Hysterectomy Under General Anaesthesia: A Rare Case Report.

Abstract

Perioperative pulmonary embolism (PE) is rare but potentially fatal and often difficult to diagnose under general anaesthesia. A fifty-one-year-old woman with hypertension and type II diabetes underwent laparoscopic hysterectomy. After pneumoperitoneum and Trendelenburg positioning, she developed hypoxemia, decreased EtCO₂, and hypotension. Hemodynamics improved after de-sufflation, but hypoxemia persisted post-extubation. Echocardiogram showed right heart strain, and computed tomography pulmonary angiography confirmed acute PE from lower extremity deep vein thrombosis. She was treated with anticoagulation therapy, vasopressor support, and inferior vena cava filter placement and discharged from intensive care unit on postoperative day 5. This case highlights the importance of early suspicion and prompt diagnostic evaluation of intraoperative PE. A multidisciplinary approach and timely anticoagulation with or without interventional therapy are critical to improve outcomes.