Deep vein thrombosis and pulmonary embolism secondary to urinary retention: a case report

J Med Case Rep. 2018 Mar 23;12(1):78. doi: 10.1186/s13256-018-1605-3.

Abstract

Background: Pulmonary embolism occurs when a blood thrombus forms and travels from a vein in the body to an artery in the lung. Thrombi often develop in one of the deep veins of the legs, thighs, or pelvis, a condition known as deep vein thrombosis. In this report, we describe a rare instance of a patient who developed deep vein thrombosis and pulmonary embolism secondary to urinary retention, and we also review some of the literature.

Case presentation: A 75-year-old Japanese man visited our hospital with the complaint of lower extremity weakness. A physical examination revealed bilateral leg edema. Contrast-enhanced computed tomography showed thrombi in both the bilateral intrapelvic veins and the right pulmonary artery, with an extremely distended bladder. We diagnosed deep vein thrombosis and pulmonary embolism due to urinary retention, which was attributed to detrusor insufficiency owing to both taking an anticholinergic drug and neurogenic bladder. The patient was immediately started on both management of voiding dysfunction and anticoagulant therapy.

Conclusions: We encountered a patient with deep vein thrombosis and pulmonary embolism secondary to urinary retention that could have been fatal. In such cases, clinicians should always take into account appropriate management of voiding dysfunction.

Keywords: Deep vein thrombosis; Neurogenic bladder; Pulmonary embolism; Urinary retention.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticoagulants / therapeutic use
  • Edema / physiopathology*
  • Humans
  • Leg / physiopathology
  • Male
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / pathology*
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / etiology*
  • Pulmonary Embolism / physiopathology
  • Pulmonary Embolism / therapy
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Urinary Bladder, Neurogenic / complications*
  • Urinary Bladder, Neurogenic / physiopathology
  • Urinary Retention / complications*
  • Urinary Retention / diagnostic imaging
  • Urinary Retention / physiopathology
  • Urinary Retention / therapy
  • Venous Thrombosis / diagnostic imaging
  • Venous Thrombosis / etiology*
  • Venous Thrombosis / physiopathology
  • Venous Thrombosis / therapy

Substances

  • Anticoagulants