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

In 257 patients undergoing total hip replacement, gastric bypass for morbid obesity, major abdominal surgery, and major leg amputation, Doppler ultrasonic screening revealed only five instances of deep vein thrombosis. The present study suggests that Doppler screening of high risk patients is a useful alternative to routine anticoagulant prophylaxis of venous thromboembolic disease.
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PMID:Prospective screening for deep vein thrombosis in high risk patients. 88 27

Charts of all patients undergoing reamed femoral nailing for traumatic femoral fractures at two level I trauma centers over 5 years were reviewed. Seven patients who met the criteria for morbid obesity (> or = 200% of ideal body weight or > or = 100 lb over ideal body weight or body-mass index > or = 37 kg/m2) were identified. There were four women and three men, average age 41.8 years, average weight 300.7 lb. The Body-Mass Index, considered the best measure of relative obesity in adults, averaged 49.2 kg/m2 (normal, 20-25 kg/m2; morbidly obese > or = 37 kg/m2). There were four femoral shaft fractures, two subtrochanteric, and one combined femoral neck-femoral shaft fracture. Surgical procedures averaged 3.8 hours in duration with an average blood loss of 1100 mL. Intraoperative and postoperative complications were numerous; difficulty in establishing a start point resulted in two fractures of the greater trochanter, and one partial trochanteric osteotomy was necessary for access in a third patient. Postoperatively two patients developed wound infections that required antibiotic treatment plus wound debridement, and four patients developed complications related to deep vein thrombosis with one fatal pulmonary embolus documented. All femoral fractures in the six surviving patients united.
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PMID:Intramedullary nailing of femoral fractures in morbidly obese patients. 811 38

The standard of care for femoral fractures is an intramedullary nail, placed in an antegrade approach. This has produced high rates of healing and low complication rates. The use of retrograde nailing for femoral shaft fractures is a relatively new technique, previously described as an extraarticular approach. Forty-one patients with 45 fractures were available for assessment after retrograde femoral nailing using an intracondylar approach. There were 2 nonunions, which healed with revision surgery, in addition to 5 other complications including: reflex sympathetic dystrophy, an ileus, deep vein thrombosis, skin loss about the knee, and malrotation noted after initial nailing. There were no postoperative infections, no arthrosis was noted, and flexion of the knee averaged 129 degrees. Retrograde femoral nailing may be used to treat fractures in patients who present with multisystem trauma; multiskeletal trauma, especially peritrochanteric and acetabular injuries; floating knee fractures; bilateral femur fractures; and patients with morbid obesity.
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PMID:Retrograde nailing of the femur using an intercondylar approach. 891 50

Two cases of fatal bleeding in patients treated with low molecular weight heparin for deep vein thrombosis are reported. Risk factors for bleeding were: severe underlying disease (cancer in one case, morbid obesity and cardiac failure in the other), age over 80 years and worsening of renal insufficiency in both cases, recent surgical procedure in one case. Anti-Xa activity was beyond the therapeutic range at the time of bleeding in both cases. The usefulness of biologically monitoring the treatment of deep vein thrombosis with low molecular weight heparin is discussed.
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PMID:[Severe hemorrhagic complications during treatment with low molecular weight heparin. Apropos of 2 cases]. 918 51

This case illustrates a potential pitfall of color flow duplex Doppler ultrasonography with compression in the evaluation of suspected deep venous thrombosis (DVT). Because of its low cost, accuracy, and noninvasiveness, ultrasonography is the appropriate first choice in the evaluation of suspected DVT, but there does exist the possibility of a false-negative examination. Magnetic resonance venography (MRV) should be reserved for cases in which there is a high clinical suspicion for DVT, as well as either morbid obesity that would limit the evaluation of deep pelvic and deep femoral veins or conflicting results of other imaging studies. All cases of suspected thrombosis, including those not adequately evaluated by ultrasonography, can be accurately assessed by MRV, which is not as invasive as standard venography.
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PMID:Thrombosis of the deep femoral vein: a potential pitfall of color flow duplex Doppler ultrasonography. 940 15

The applicability of laparoscopic donor nephrectomy (LDN) has not been assessed in the obese donor. We hypothesized that obesity is not a technical contraindication to LDN. From May 1998 to February 1999, 40 patients underwent LDN at the Georgetown Transplant Institute with the transperitoneal technique. Prophylaxis against deep venous thrombosis consisted of venous compression stockings, low-molecular weight heparin in obese patients, and early ambulation. The following variables were examined: donor sex, age, weight, height, related versus nonrelated donation, body mass index (BMI; wt/ht2), operating room time, estimated blood loss, length of stay, time out of work, and complications. BMI>31 indicates morbid obesity, BMI>27 indicates >20% over ideal body weight, and normal BMI is 25. The patients were divided into nonobese (BMI< or =31) and obese groups (BMI>31). The two groups do not differ in outcome after LDN. Our data indicate that obesity is not associated with increased morbidity or mortality after LDN.
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PMID:Outcomes of laparoscopic donor nephrectomy in obese patients. 1065

Risk factors and prophylaxis for prevention of deep venous thrombosis (DVT) and pulmonary embolism remain controversial in burn patients. From January 1996 through June 1999, we reviewed all adult burn patients admitted to our burn center with the in-hospital diagnosis of DVT and assessed each affected patient for DVT risk factors. There were 8 symptomatic DVTs and 2 pulmonary embolisms detected in 327 adult burn patients (2.4% incidence). No DVT patient had the risk factors of morbid obesity, previous DVT, congestive heart failure, or neoplastic disease. One patient was older than 65 years. All of the DVTs occurred in veins draining a burned extremity. Seven of 8 patients had burn wound infections as complications. Burns on the extremity developing the DVT as well as the diagnosis of a burn wound infection were significant risk factors for DVT formation. These findings prompt us to consider routine screening for DVT in burn patients with these risk factors.
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PMID:Potential risk factors for deep venous thrombosis in burn patients. 1130

The aim of this study was to investigate prospectively the incidence of deep venous thrombosis (DVT) after surgery for morbid obesity. The series comprised 116 consecutive patients undergoing Roux-en-Y gastric bypass. The median age and body mass index were 35 years (range 19-59 years) and 42 kg/m2 (range 32-68 kg/m2), respectively. The patients were examined with duplex ultrasonography pre- and postoperatively. No patient had any symptoms or signs of DVT postoperatively, and ultrasonography showed no signs of thrombosis in iliac, femoral, and popliteal veins in any of the patients. Two patients (1.7%) had a thrombus in the peroneal vein of one leg. Repeated ultrasonographic investigation after 1 week showed complete resolution of both. One patient with a previously unknown activated protein C resistance had an angiographically confirmed minor pulmonary embolus. The incidence of venous thromboembolism after obesity surgery seems to be low, and obesity as a risk factor for thromboembolic disease might have been overestimated in the past.
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PMID:Incidence of deep venous thrombosis in patients undergoing obesity surgery. 1191 Apr 82

The purpose of this report was to describe clinical and ultrasound findings associated with venous thromboembolism of the lower extremities and pulmonary embolism observed in our department with special emphasis on the utility of venous ultrasound in the diagnosis of venous thromboembolism. Between January 1, 1998 and December 31, 1999, a total of 47 venous ultrasound procedures were carried out according to the standard technique using a Logic 400 MD system (General Electric). Deep venous thrombosis was diagnosed in 18 cases (38.3%). There were 10 men and 8 women with a mean age of 46 years (range, 24 to 71 years). Thrombosis involved the internal saphenous, popliteal, or sural vein in 12 cases, the common or deep femoral vein in 4, and the external iliac vein in 2. The most common risk factors observed in our series were surgery, predisposing conditions, history of venous thrombosis and morbid obesity (66.8% of case). Prolonged periods of bed confinement and neoplasm (lower extremity Kaposi's disease) were more uncommon (22.2%). Pulmonary embolism occurred during the observation period in six cases (33.3%) including 3 (50%) that were fatal. Based on these findings it can be concluded that although its incidence is relatively low in black African patients at risk, thromboembolic disease is often fatal and requires routine preventive treatment using heparin.
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PMID:[Venous thromboembolism in Cameroon (report of 18 cases)]. 1203 77

Morbid obesity is a serious disease that is responsible for several co-morbid conditions. Increased risks of hypertension, adult onset diabetes mellitus, dyslipidemia, pulmonary disease (Pickwickian syn- drome), musculo-skeletal disorders, gallbladder disease, deep vein thrombosis, venous stasis ulcers, and increased prevalence of certain types of cancers (uterine, breast, colon carcinoma) have been reported, ( together with severe psychological and social disability.' Nonsurgical treatment options including various combinations oflow-calorie or very-low-calorie diets, behavior modification, exercise, and drug therapy may achieve acceptable transient weight reduction but fail to maintain reduced body weight in most patients.'
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PMID:Laparoscopic adjustable silicone gastric banding (LASGB) for the treatment of morbid obesitiy. 1585 31


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