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

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.