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

Radionuclide diagnostic imaging is an important adjunct to the diagnosis and treatment of several conditions that present to the emergency department. The emergency physician should be able to properly apply these tests. A normal radionuclide perfusion lung scan can reliably rule out pulmonary embolism. The use of the radionuclide ventilation lung scan may help interpretation of a perfusion lung scan that is of intermediate probability for pulmonary embolism. A radionuclide venogram of the lower extremities is both sensitive and accurate for detecting the presence of deep venous thrombosis. A radionuclide testicular scan is invaluable in the workup of the acute scrotum, as long as the test is available in a timely manner and the diagnosis has not been established by another means. A multiple-gated acquisition cardiac scan can help make the diagnosis of cardiac contusion after other causes of cardiac instability have been corrected. The renal radionuclide scan is useful in the workup of obstructive uropathy, especially if intravenous pyelography is contraindicated. The hepatobiliary nuclear scan is able to help differentiate acute cholecystitis from other causes of right upper quadrant pain. Proper and timely use of these tests can prevent serious sequelae from a missed diagnosis, and in some cases eliminate the need for invasive tests, dangerous treatment, or even exploratory surgery when it is unwarranted.
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PMID:Emergency radionuclide scans. 351 91

One encounters a variety of radiopaque foreign objects when reviewing plain film radiographs of the abdomen. Recognizing such devices can offer important clues about a patient's medical history. Accordingly, intrauterine contraceptive devices (IUCD), tubal sterilization, varicoceles, inferior vena cava (IVC) filtration, and vaginal pessaries are discussed with reference made to an IUD, tubal sterilization clips, embolization coils for bilateral varicoceles, an IVC filter, and a vaginal pessary in five attached anteroposterior radiographs of the lower abdomen and pelvis for five different patients. IUCDs confer long-term, passive, reversible, and inexpensive protection against unwanted pregnancy. They may, however, induce menstrual complications as well as an increased risk of pelvic inflammatory disease and ectopic pregnancy. They can also be spontaneously expelled from the uterus without being noticed by the client. An IUCD increases the risk of spontaneous abortion unless removed in cases where intrauterine pregnancy occurs. Complications at the time of insertion include pain, syncope, and uterine perforation. Tubal sterilization is an effective, though largely irreversible method of contraception. Complications include an increased risk of ectopic gestation in the event of pregnancy and the usual risks of hemorrhage, infection, injury to adjacent structures, and anesthesia-related complications. A varicocele is a dilation of the pampiniform venous plexus of the scrotum. They are more often unilateral than bilateral, occurring in up to 20% of men most often on the left side. Although most cases are probably insignificant, varicoceles can decrease sperm count and motility and cause abnormal morphology. Correction of varicoceles has been shown to improve sperm quality and can increase the chances of fertility. Percutaneous venous embolization techniques have recently been developed to that end. Procedural risks include perforation of the vein, intimal dissection, inadvertent embolization of vessels via collateral channels, and reactions to contrast media. IVC filters are a feasible alternative treatment for deep venous thrombosis and pulmonary embolism among patients in whom anticoagulants are contraindicated or for those in whom anticoagulation therapy has failed. Introduced via the femoral or jugular veins, they are permanent metallic devices placed within the lumen of the IVC to filter thrombi which migrate from the deep veins of the lower extremities. Contraindications to IVC filter insertion include severe coagulopathy and thrombosis involving all venous access routes, while complications include hematoma at the insertion site, migration or tilting of the device due to poor anchoring in the IVC wall, and vena cava obstruction. A pessary is a prosthetic device used to support pelvic structures when their natural support is lacking. They are usually made of plastic or rubber and inserted into the vagina to aid in the non-operative treatment of uterine prolapse, proctoceles, and cystoceles. They must be properly fitted and removed every few months for cleaning.
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PMID:Radiology rounds. Intrauterine contraceptive device. 821 57

We report a case of radiation-induced venous stenosis after pelvic irradiation to treat Paget's disease of the scrotum. During therapeutic anticoagulation, significant left lower extremity swelling developed due to an iliofemoral deep venous thrombosis (DVT). After percutaneous thrombectomy and thrombolysis, a high-grade stenosis was uncovered in the left external iliac vein, which was treated with an endoluminal stent. However, ipsilateral DVT recurred 2 months later despite continued anticoagulation therapy. Repeat treatment was successful. Pelvic radiation is a potential cause of iliac vein stenosis. Pharmacomechanical thrombectomy may have a useful role in management of complex iliofemoral DVT.
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PMID:Radiation-associated venous stenosis: endovascular treatment options. 1521 82

A chronically catheterized 14-y-old male rhesus macaque (Macaca mulatta) was reported for recurrent scrotal swelling. The scrotum was enlarged and warm to touch, and associated skin was noted to be lichenified on physical examination. The penis could not be extruded due to preputial swelling. Results from the following diagnostic tests were all unremarkable or within normal limits: scrotal aspirate, hematology, serum biochemistries, urinalysis, and radiography of the thorax, scrotum, and abdomen. Ultrasonography of lower extremities identified thrombi in bilateral iliac veins and left femoral vein. Collateral circulation surrounding the left femoral vein permitted some compensatory venous return. The left femoral vein of this animal had been catheterized approximately 2 mo before initial presentation. A coagulation panel revealed a positive D-dimer test, indicative of elevated levels of fibrin degradation products due to active thrombus breakdown. Enoxaparin sodium, a low-molecular-weight heparin for human use, was administered at 20 mg subcutaneously once daily for 10 d to treat occlusive venous thrombi. After enoxaparin treatment, the edema was greatly decreased. To achieve complete resolution, a second course of enoxaparin was administered 2 months after the first. Ultrasonography of the pelvic vasculature 6 mo after completion of therapy showed marked thrombus resolution, allowing for bilateral patency in the iliac and femoral veins. Follow-up evaluation revealed that D-dimer values were negative as well. This case demonstrates the novel application of the human medication enoxaparin to treat clinical signs of deep vein thrombosis in a chronically catheterized rhesus macaque.
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PMID:Enoxaparin treatment of spontaneous deep vein thrombosis in a chronically catheterized rhesus macaque (Macaca mulatta). 1980 74