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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A prospective study comparing real-time ultrasound scanning with contrast venography in the diagnosis of deep venous thrombosis of the lower limb was performed in a group of 46 patients. The sensitivity of ultrasound scanning for thrombus within the iliofemoral segment, femoral vein, and popliteal vein was 94% with a specificity of 100%. Additional information obtained by ultrasound included the diagnosis of popliteal cysts, pelvic and inguinal lymphadenopathy, popliteal haematoma, and traumatic arterial aneurysm. Real-time ultrasound scanning is a rapid and non-invasive alternative to contrast venography in the diagnosis of lower limb deep venous thrombosis.
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PMID:Real-time ultrasound diagnosis of deep vein thrombosis: a comparison with venography. 355 62

Primary thrombosis of the deep veins of the upper arms accounts for less than 2% of total cases of deep venous thrombosis, and fewer than 10 reported cases of venous thromboembolism in association with oral contraceptive (OC) use have involved the upper extremity. This article describes the case of a 20-year old woman with recurrent arm swelling and pain who had been in good health until developing a small area of redness in her right arm and fever to 99.8 degrees Fahrenheit 6 weeks previously. The condition had been diagnosed as spider bite, for which no medication was given, and cellulitis with axillary lymphadenopathy, for which oral antibiotics were prescribed. Gradual improvement in pain and swelling occurred, but the arm did not return to normal size or consistency. Hospitalization and treatment with 9 days of intravenous Cefamandole provided some resolution. The patient had taken OCs for 2 1/2 years to regulate menses and was a cigarette smoker. She was discharged on oral Tetracycline but was referred for further evaluation because of persistent symptoms. The physical examination was normal except for an increased right upper extremity circumference, increased turgor of upper arm tissues, and some tenderness along the axillary vein and in the axilla itself. A venogram showed complete obstruction of the axillary and subclavian veins on the right with remarkable collateral circulation. The superior vena cava was patent. Treatment with intravenous Heparin followed by oral Warfarin produced no improvement in clinical condition. Primary upper extremity thrombosis is generally a disease of young men. In this case OCs may have served as a thrombogenic risk factor.
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PMID:A painful swollen arm in a young woman. 657 28

Preliminary experience with uro-laparoscopy was retrospectively analyzed to determine whether patients profited from the laparoscopic procedure. Between August 1991 und July 1993 we performed 53 operations laparoscopically. Four more began in this way but ended in open surgery. 29 varicocele procedures were carried out. A reduced postoperative morbidity, and hence a benefit, were obvious in 3/29 patients with bilateral varicocele, but probably not in the remaining 26/29 patients affected only on the left side. 13 pelvic lymphadenectomies in patients with prostatic carcinoma T1-3, elevated prostatic acid phosphatase, a PSA > 30 ng/ml and/or a suspected N+ on CT, served to identify 10 pN0 and 3 pN1 patients. Four of the pN0 patients with a T3 tumor were given radiotherapy. Six with a T2 tumor underwent radical prostatectomy, four with margin-negative specimens benefited from laparoscopic lymphadenectomy by securing a curative operation which according to established rules would otherwise have been withheld. Two patients with margin-positive specimens suffered harm from laparoscopic lymphadenectomy, which had led to a needless operation. Another lymphadenectomy performed on one more patient suffering from deep venous thrombosis of the left leg associated with pelvic lymphadenopathy established the benign histology of the enlarged lymph nodes with minimal morbidity. 10 nephrectomies were carried out for benign, clinically relevant lesions of the kidney, which are rare. They produced a clear-cut benefit for all patients as the postoperative morbidity was minimal. We conclude that the present indications for uro-laparoscopic procedures are either disputable or rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Initial experience with surgical uro-laparoscopy]. 825 80

Twenty-four consecutively hospitalized patients with clinical evidence of lower extremity deep vein thrombosis (DVT) had blinded ipsilateral ultrasonographic duplex imaging (US), contrast venography (VG), and a one-time bilateral impedance plethysmography (IPG) examination. The cases of eight (33%) of the study patients were thought to be complicated due to a prior history of DVT or the presence of ipsilateral inguinal adenopathy. Interpretable test results were obtained for 100% of the US examinations, 88% of the VG studies, and 75% of the IPGs. One additional subject, included in our study for statistical analysis, had an unblinded false-negative US examination; in this case DVT was shown by VG but could not be seen on US despite the radiologist's prior knowledge. The sensitivities, specificities, and 95% confidence intervals for the three studies were as follows: US, 92% (81% to 103%) sensitivity, 100% (99% to 101%) specificity; VG, 100% (99% to 101%) sensitivity, 75% (58% to 96%) specificity; IPG, 50% (30% to 70%) sensitivity, 83% (68% to 98%) specificity. Of the six indeterminate IPG studies, four (67%) occurred in complicated cases. These data suggest that US should be the first-line noninvasive screening study done for evaluation of suspected DVT, especially in complicated cases.
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PMID:Comparison of venography, duplex imaging, and bilateral impedance plethysmography for diagnosis of lower extremity deep vein thrombosis. 828 19

A 77-year-old man was referred with a 5-year history of an intermittently painful, nonhealing right medial ankle ulcer. The ulcer had not responded to multiple treatment modalities, including Unna boots, compression therapy, sclerotherapy, and split-thickness skin grafting. The past medical history was significant for a deep venous thrombosis in the right leg 30 years earlier (treated with warfarin for 3 months) and a history of greater saphenous vein harvesting for coronary bypass grafting 28 years previously. After the vein stripping, the patient had suffered from increasing right leg edema and stasis changes in the right leg. His history was also remarkable for coronary artery disease, dyslipidemia, and lymphoma treated with chemotherapy 8 years before presentation, with no evidence of recurrence. He had stopped smoking approximately 20 years earlier. Medications included atenolol, simvastatin, nicardipine, nitroglycerin, and aspirin. Skin examination revealed a 3.0 x 3.5-cm ulcer adjacent to the medial malleolus. The edges of the ulcer appeared raised and rolled (Fig. 1). Centrally, there was granulation tissue, which appeared healthy. There were surrounding dermatitic changes. Dorsalis pedis and the posterior tibial pulses were normal. Noninvasive vascular studies revealed severe venous incompetence of the right popliteal and superficial veins. Arterial studies and transcutaneous oximetry were normal. Computed tomographic scan of the pelvis did not reveal any adenopathy, and radiographic imaging did not reveal any bony changes suggestive of osteomyelitis. Biopsy of the ulcer edge and base showed infiltrating basal cell carcinoma (Fig. 2). Mohs' micrographic surgery required three layers; the final extent of the ulcer was 7.8 x 6.9 cm. A split-thickness skin graft was placed.
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PMID:Infiltrating basal cell carcinoma in the setting of a venous ulcer. 1094 Jan 16

A 27-year-old man with advanced testicular cancer experienced two events of deep vein thrombosis (DVT) during three cycles of cisplatin-based combination chemotherapy; the first thrombotic event occurred in the inferior vena cava (IVC) following the initial two cycles of chemotherapy and the second thrombotic event occurred in the right iliac vein following the third cycle. For both thrombotic events, he was successfully managed with thrombolytic therapy and percutaneous thrombectomy using a transcatheter hydraulic thrombectomy device under temporary placement of a retrievable IVC filter. Stasis of the IVC due to compression by a retroperitoneal lymphadenopathy of 7 cm in diameter, which was demonstrated on computed tomographic scans at presentation, was considered a major cause of DVT during chemotherapy. Patients with bulky retroperitoneal disease causing stasis of major veins are at high risk of DVT associated with chemotherapy and thromboprophylaxis should be strongly considered during their chemotherapy.
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PMID:Deep vein thrombosis during chemotherapy in a patient with advanced testicular cancer: successful percutaneous thrombectomy under temporary placement of retrievable inferior vena cava filter. 1124 Aug 34

Advanced rectal carcinoma usually presents with rectal bleeding, tenesmus or alteration in bowel habits. Secondary deposits in the inguinal lymphnode is generally an indication of advanced disease. We report unusual presentation of advanced rectal carcinoma in a 23 year-old female patient who came presenting with symptoms of left inguinal lymphadenopathy and left leg swelling. There were no symptoms related to local effects of rectal carcinoma. First the patient was treated as a case of deep venous thrombosis. Fine needle aspiration biopsy provided the first clue to the nature of disease. To the best of our knowledge such unusual presentation of advanced rectal carcinoma has never been reported in Ethiopia. Rectal carcinoma should be considered in the list of secondary adenocarcinoma in the inguinal lymphnodes.
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PMID:Unusual presentation of rectal carcinoma in a young woman. 1195 16

A 20-year-old man was referred to our hospital because of leukocytosis and was diagnosed as having chronic myelogenous leukemia in lymphoblastic crisis. His left leg began to swell soon after the beginning of induction chemotherapy and deep vein thrombosis (DVT) was confirmed by doppler echography, which progressed to compartment syndrome next day. After placing a venous filter in the inferior vena cava, the patient successfully underwent thromboembolectomy. Venous congestion due to massive lymphadenopathy enlarged kidneys, and a hypercoagulable condition due to the rapid destruction of leukemic cells may have contributed to the formation of the thrombus. This case demonstrates the importance of aggressive surgical intervention for severe DVT in patients with leukemia.
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PMID:[Chronic myelogenous leukemia in a lymphoblastic crisis complicated with deep venous thrombosis successfully treated by thromboembolectomy]. 1463 53

Omental metastasis with malignant ascites from prostatic adenocarcinoma is rare. This case report is about a patient who presented with a 24-hour history of a swollen right leg. Clinical examination revealed a hard prostate and blood biochemistry demonstrated an elevated prostate specific antigen level. A Doppler ultrasound scan excluded deep venous thrombosis, but a CT scan of the abdomen revealed marked para-aortic lymphadenopathy and prostate gland biopsy confirmed prostatic adenocarcinoma. The patient was treated with goserelin. Three years later, he presented with ascites and an omental mass. Histology of the omental mass showed metastasis from the prostatic adenocarcinoma. He was treated with second-line hormonal therapy but died after 4 months. We discuss the clinical progression, with a review of the literature.
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PMID:Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma. 1854 9

We depict a case of a 32 year old Mediterranean man, presenting with pulmonary embolism, and diffuse arterial thrombosis of the lower extremities. CT angiography revealed bilateral pulmonary artery occlusions and a mediastinal lymphadenopathy. Duplex Ultrasound of the lower extremities showed no deep venous thrombosis, but occluded popliteal arteries bilaterally with extension to the right distal superficial femoral artery. Mediastinoscopy with hilar lymph node biopsy showed noncaseating granulomas consistent with sarcoidosis. Thrombophilia profile revealed factor II, MTHFR, and factor XIII gene mutations with markedly elevated homocysteine level of 139 mumol/l. This is an atypical rare case of sarcoidosis presenting with pulmonary embolism and multiple arterial thrombosis.
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PMID:Unusual presentation of a sarcoid patient: multiple arterial and venous thrombosis with chest lymphadenopathy. 1879 62


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