Open AccessSuspected pulmonary embolism postcesarean section in a patient with autosomal dominant polycystic kidney disease
Author(s) -
Olusegun O. Badejoko,
Olufunke Dada,
Akaninyene Eseme Ubom,
Olumuyiwa Tope Ajayeoba
Publication year - 2020
Publication title -
nigerian medical journal/nigerian medical journal
Language(s) - English
Resource type - Journals
eISSN - 2229-774X
pISSN - 0300-1652
DOI - 10.4103/nmj.nmj_99_20
Subject(s) - medicine , autosomal dominant polycystic kidney disease , pulmonary embolism , acute kidney injury , pregnancy , disease , polycystic kidney disease , surgery , preeclampsia , intensive care medicine , biology , genetics
Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetically inherited kidney disease worldwide. It is however relatively underdiagnosed in Africans because its diagnosis is often incidental. During pregnancy, ADPKD is associated with increased risk of preeclampsia and venous thromboembolism. The case of a 33-year-old lady incidentally diagnosed with ADPKD during pregnancy is presented. She developed preeclampsia at term and had cesarean delivery of twins. She however suffered cardiopulmonary arrest postoperatively and this created a treatment dilemma because therapeutic anticoagulation which was the primary treatment for her suspected pulmonary embolism was absolutely contraindicated if the actual cause of her collapse was ruptured cerebral aneurysm which was also a feature of ADPKD. We decided to resuscitate aggressively and perform an urgent cranial computed tomography which ruled out intracranial hemorrhage. We then commenced anticoagulation and she made an excellent recovery. This case illustrates the importance of a timely multidisciplinary approach to patient management.