Fatal pulmonary embolism occurs in 0.1% to 0.26% of cases of spine fusion surgery. Early diagnosis of pulmonary embolism is difficult, and delay in treatment can lead to a fatal outcome. We report on a case of symptomatic pulmonary embolism which developed after induction of general anesthesia in a patient who had been immobile because of a previous spinal operation one week prior to this. Despite a negative preoperative ultrasound examination for deep vein thrombosis, the patient had developed a pulmonary embolism, which was diagnosed using intraoperative transesophageal echocardiography. Despite intensive cardiopulmonary resuscitation and thrombolytic therapy, the patient died within a few hours of diagnosis.

• Ki Tae Jung(Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Department of Anesthesiology and Pain Medicine, Chosun University Hospital)
• Sang Hun Kim(Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Department of Anesthesiology and Pain Medicine, Chosun University Hospital)
• Hyo Sung Bae(Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University)
• Jong Dal Jung(Department of Anesthesiology and Pain Medicine, School of Medicine, Chosun University, Department of Anesthesiology and Pain Medicine, Chosun University Hospital) Corresponding author