Korean Journal of Critical Care Medicine  2015;30(3):227-230

doi:10.4266/kjccm.2015.30.3.227

Unexpected Multiple Organ Infarctions in a Poisoned Patient.

Sung Wook PARK ; Sang Kyoon HAN ; Seok Ran YEOM ; Soon Chang PARK ; Sung Hwa LEE

Keywords

infarction; thrombophilia; venous thromboembolism

Country

Republic of Korea

Language

English

Abstract

Predisposing factors for venous thrombosis can be identified in the majority of patients with established venous thromboembolism (VTE). However, an obvious precipitant may not be identified during the initial evaluation of such patients. In the present case, a 47-year-old female presented to the emergency department of our hospital after ingesting multiple drugs. She had no VTE-related risk factors or previous episodes, nor any family history of VTE. After admission to the intensive care unit sudden hypoxemia developed, and during the evaluation cerebral, renal, and splenic infarctions with pulmonary embolisms were diagnosed. However, the sources of the emboli could not be identified by transthoracic echocardiography or computed tomography angiography. Protein C deficiency was identified several days later. We recommend that hypercoagulable states be taken into consideration, especially when unexplained thromboembolic events develop in multiple or unusual venous sites.