Combined oral contraceptives (OCs) are a common method of contraception; however, they are associated with a twofold to sixfold increased risk of venous thrombosis (VT). The association between estrogen-containing OCs and VT is well established. After the first generation progestogens, new progestogens were developed. However, the risk of VT is higher for users of OCs with third generation progestogens than for those using second generation progestogens. We experienced a patient, a 25-year-old young woman with chest pain after taking third generation OCs. We performed chest computed tomography (CT) and lower extremity venogram CT. She was diagnosed with a pulmonary thromboembolism and deep vein thrombosis. She was treated with low molecular weight heparin and warfarin for six months. We report on this case with a review of the relevant literature.

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.