Presentation
Left sided pleuritic chest pain and right calf pain
Patient Data
The chest x-ray demonstrates the Hampton hump sign, a dome-shaped area of opacification in the periphery of the left lower lobe.
- Pulmonary emboli in the right middle and lower lobar branches, as well as the right lower lobe lateral and posterior segmental branches
- Pulmonary emboli in the left lower lobe branch and left lower lobe superior, anteromedial, lateral and posterior segmental branches
- Area of consolidation with internal air lucencies in the left lower lobe lateral segment representing lung infarction
Case Discussion
This case demonstrates the Hampton hump sign with a subsequent CTPA confirming the diagnosis of pulmonary emboli with lung infarction in the area corresponding to the left lower lobe peripheral opacity on chest x-ray.
Risk factors for pulmonary embolism in this patient were:
- recent long overseas flight
- smoking
- oral contraceptive pill
A subsequent ultrasound confirmed the presence of a unilateral lower limb DVT in the right peroneal and popliteal veins.
The patient was commenced on a factor Xa inhibitor anticoagulant medication, smoking cessation encouraged and the oral contraceptive pill was ceased.