case_images: PMC7457691_01
case_images: (a) X-ray: the rupture of tibia and fibula. (b) Abdominal CT: liver trauma. (c) Chest
  CT pulmonary angiography: thrombus in PA.
case_images: 10.1177_2050313X20953753-fig1.jpg
case_images: PMC7457691_01_10.1177_2050313X20953753-fig1.jpg
case_images: fig1-2050313X20953753
case_images: A 65-year-old woman had traffic accident with liver trauma and open fracture of both tibia and fibula on the right side (Figure 1(a)). The liver sonography and computed tomography (CT) saw laceration with 11 cm in length, 4 cm parenchymal depth, and parenchymal contusion in IV, V, VI lower lobes without active bleeding (Figure 1(b)). An urgent chest CT pulmonary angiography revealed massive PE and pleural effusion (Figure 1(c)).
case_images: (a) Pathological specimen from surgical pulmonary embolectomy. (b) CT pulmonary
  angiography of pulmonary artery after surgery.
case_images: 10.1177_2050313X20953753-fig2.jpg
case_images: PMC7457691_01_10.1177_2050313X20953753-fig2.jpg
case_images: fig2-2050313X20953753
case_images: Under direct vision, blood clots in left pulmonary artery were taken out by Miniry (special instrument for bile-stone removal) (Figure 2(a)) and left PA purified by warm solution of NaCl 0.9%. Post-operative CT pulmonary angiography revealed good result, PA without thrombus, and good deflated lungs (Figure 2(b)).