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This report aims to highlight the unusual presentation of pulmonary embolism (PE) as backache after appendectomy.

March 2, 2026Journal of Investigative Medicine High Impact Case Reports0 citationsOpen Access

Pulmonary Embolism Presenting as Backache After Appendectomy: An Atypical Presentation of a Common Diagnosis

Key Points

This report aims to highlight the unusual presentation of pulmonary embolism (PE) as backache after appendectomy.
Describes a case of a 39-year-old male presenting with back pain after laparoscopic appendectomy.
Confirmed diagnosis through computed tomography pulmonary angiography.
Discusses pathophysiological mechanisms behind atypical presentations of PE.
Patient was diagnosed with acute pulmonary embolism two weeks post-appendectomy.
Initial symptom was isolated right lower-back pain, complicating timely diagnosis.
The case emphasizes the need for awareness of atypical PE presentations to enhance early recognition.

Abstract

Pulmonary embolism (PE) is a disease with diverse clinical manifestations, which lacks specificity but may be life-threatening. We describe a 39-year-old male who presented with acute PE complicated by pulmonary infarction, confirmed by computed tomography pulmonary angiography 2 weeks following laparoscopic appendectomy. His initial symptom was right lower-back pain. This case underscores the diagnostic challenge posed by an atypical presentation of PE, in which isolated back pain was the sole initial manifestation. Furthermore, we delineate the pathophysiologic mechanisms that may account for PE presenting initially as isolated back pain, knowledge that could expedite early recognition and guideline-directed anticoagulation.

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