Fatal intra-alveolar pulmonary bleeding complicating pulmonary embolectomy.

Pulmonary haemorrhage after embolic occlusion of a pulmonary artery usually follows the infarction of lung parenchyma. This complication is particularly prevalent in patients suffering from chronic congestive cardiac failure. The usual finding in such cases is obstruction of a segmental or smaller artery with infarction of the parenchyma supplied by it. The haemorrhage itself is usually slight and unimportant as regards eventual prognosis. Parenchymal bleeding following obstruction of the main branches of the pulmonary artery, without overt evidence of infarction, and severe enough to cause death at a time when the obstructing embolus has been removed, is a rare event The purpose of this communication is to describe two patients in whom fatal pulmonary haemorrhage occurred following the removal of the obstructing clot. This complication of pulmonary embolectomy is relevant, as several nonoperative methods of treating acute pulmonary embolism have recently been introduced.