CTICasesPulmonary Hemorrhage Secondary to Acute Pulmonary Embolism presenting as Abdominal Pain
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Imaging findings
Abdominal CT extending through the lung bases and dedicated non-contrast chest CT demonstrate extensive ground-glass opacity, interstitial and bronchial wall thickening, and confluent consolidation in the right lower lobe, accompanied by a pleural effusion. Contrast-enhanced CT reveals a large, occlusive pulmonary embolus within the right lower lobe pulmonary artery.
Key takeaways
Lower lobe pulmonary embolism can cause diaphragmatic irritation and refer pain to the abdomen, prompting initial evaluation via abdominal CT. Pulmonary hemorrhage without true alveolar necrosis is pathologically far more common than true pulmonary infarction following an embolism. On CT, these infarctions or hemorrhages classically present as peripheral consolidations lacking air bronchograms, which can easily be misdiagnosed as routine bacterial pneumonia.
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