1Department of Forensic Medicine, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka
2Department of Anaesthesiology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka
3Department of Pathology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka
4Department of Pathology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka
Online published on 24 February, 2012.
In situ pulmonary artery thrombosis (PAT) in adults is a potentially life-threatening disorder rarely recognized ante mortem. The literature pertaining to PAT is limited to isolated clinical case reports or small descriptive pathological series stating a close association with concurrent morbidity such as thrombophilia, pneumonia or pulmonary arterial flow disturbance.
A rare case of extensive in situ central pulmonary artery thrombosis in organophosphorous poisoning is presented. We report a case of 37-year-old woman with history of consumption of organophosphorous compound (mahaphos). She presented with vomiting, drowsiness, poor response to oral commands, fasciculations and shallow breathing. She was admitted and treated in ICU for 20 days wherein her general condition improved. She developed respiratory distress and collapsed all of a sudden. On autopsy, she had a large immobile wall-adherent thrombus located in the pulmonary trunk extending into the right pulmonary artery. Left pulmonary artery showed emboli and right coronary artery showed a thrombus attached to the arterial wall. Histopathology revealed multiple areas of infarction in lung and wide spread toxic injury to hepatocytes, spleen and kidney.
We conclude that op compound poisoning caused wide spread endothelial damage resulting in pulmonary and coronary thrombosis leading to cardiac arrest.
Organophosphorus (OP), pulmonary artery, coronary artery thrombosis
