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

Studies on the management of inferior vena cava (IVC) thrombosis have rarely focused upon the risk of later development of post-thrombotic syndrome of the lower limbs. From 1983-1989, 52 patients with ilio-femoral thrombosis with an extension of thrombus into the IVC were treated. In addition to lower limb pain and swelling, 12 (23%) patients had symptomatic pulmonary embolism on admission. Perfusion/ventilation pulmonary scans were positive in 63%. Twelve patients received only anti-coagulant treatment. Thrombectomy was attempted in 40 patients, but failed in 13 patients due to old thrombi. Twenty-seven patients had surgical removal of thrombus combined with anti-coagulation [temporary arterio-venous fistula (AVF) and IVC interruption (n = 15); AVF alone (n = 9); and without fistula n = 3)]. The mortality and morbidity were low and hospital stay was not prolonged. Thirty-eight legs were examined at 7-66 months (mean: 23 +/- 3) after initial treatment. The limbs in which the IVC thrombus could not be removed (n = 20) were symptomatic in 25% of patients, venous ulcer developed in 4 of 20 limbs. The ilio-femoral segment was patent in only 35%. The thrombectomised limbs (n = 18) were asymptomatic in 56%; none had developed ulcer and iliac patency was 72%. Doppler investigations and refilling times were normal in 39% of the thrombectomised limbs. All patients without surgical IVC thrombus removal developed contralateral deep venous thrombosis during the follow-up period. This study shows that femoro-ilio-caval thrombectomy is successful only in patients with a short history and fresh clot, and can be safely performed with low morbidity and mortality.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Surgical removal of an inferior vena cava thrombus. 155 74

In a five-year case-control study (1988 to 1993) at Assir Central Hospital (ACH), Abha (8,000 feet above sea level), Saudi Arabia, 92 of 129 patients suspected of deep venous thrombosis (DVT) were studied with ascending contrast venography (CV) (74 patients, 80.4%) or Doppler ultrasonography (DUS) (18 patients, 19.6%). Female-to-male ratio was 2.3 to 1. Age range of patients was twelve to ninety years; mean age was 44.45 yrs +/- 17.38 years. DVT hospital incidence was 18 per 10,000 admissions. The most common associated factors included immobilization due to chronic diseases (21.7%), trauma and surgery (19.6%), and pregnancy and oral contraceptives usage (16.3%). The most common symptom and sign were limb pain and tenderness (95.6%). Limb swelling was noted in 93.5% of patients. The left lower limb was more commonly affected than the right. There was a definite increase of DVT during the winter months. Altitude was not a contributory factor. Pulmonary embolism was the greatest complication.
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PMID:Deep venous thrombosis in Assir region of Saudi Arabia. Case-control study. 749 16

Children who present with unilateral or bilateral swelling of the legs are often suspected of having a deep venous thrombosis. The incidence of deep venous thrombosis in children is low and lymphoedema may be a more appropriate diagnosis. Lymphoedema can be primary or secondary. In childhood, primary lymphoedema is more common and may be seen associated with other congenital abnormalities, such as cardiac anomalies or gonadal dysgenesis. Primary hypoplastic lymphoedema is the most often encountered type. It is more common in girls, especially around puberty, and is typically painless. Atypical presentations produce diagnostic confusion and may require imaging to confirm the presence, extent, and precise anatomical nature of the lymphatic dysplasia. This article describes four patients presenting with limb pain and reviews the clinical features and imaging options in children with suspected lymphoedema.
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PMID:The swollen leg and primary lymphoedema. 806 92

DVT is a potentially serious disease and can serve as a marker for PE, an entity with even higher morbidity. Thus, it is critically important that emergency physicians consider this diagnosis in patients who present with suspicious symptoms. Recognition of alternative conditions, such as compartment syndrome, septic arthritis, and cellulitis, is also important for optimal care. Because physical examination is only 30% accurate for DVT, it serves to increase clinical suspicion in patients at risk but cannot be used to eliminate the possibility of thromboembolic disease. Because of this limitation, the diagnosis of DVT should be pursued using adjunctive testing in any patient with unexplained limb pain or swelling. Duplex sonography is currently the initial diagnostic study of choice for evaluation of DVT and, if test results are negative, it should be repeated serially if the clinical suspicion is high.
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PMID:Physical examination findings in deep venous thrombosis. 1176 76

The postthrombotic syndrome (PTS) is a clinical condition of limb pain along with physical findings that range from swelling to stasis ulcers following one or more episodes of deep vein thrombosis (DVT). While venous thromboembolism has recently gained increased recognition in children, the sequelae of limb thrombi are being recognized in a substantial proportion of affected children, and with varying degrees of severity. PTS is caused by both obstructed as well as refluxed venous blood flow, with combined effects of obstruction and reflux resulting in earlier, and more extensive symptoms. PTS can be diagnosed using an evaluation tool adapted from an international adult scale. Certain risk factors predispose children to PTS including elevations in factor VIII activity and D-dimer, clot occlusiveness, clot persistence, number of venous segments involved and duration of observation following DVT. Optimal prevention and treatment have not yet been determined, although antithrombotic therapy to facilitate rapid clot resolution, elevation, compression, moderate exercise and achievement of optimal body weight are likely to improve outcome.
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PMID:Postthrombotic syndrome in children. 1654 98

The objective of this report is to represent a case of reflex sympathetic dystrophy (RSD) secondary to the upper extremity deep venous thrombosis (DVT). A 21-year-old man admitted with the complaints of pain and swelling in his right upper limb was presented. The patient had been diagnosed DVT in the right subclavian vein. The thrombosis had recovered completely with the standard treatment of DVT and doppler ultrasound had revealed normal findings at follow-up. After few months, he developed limb edema and pain considering post-thrombotic syndrome (PTS). The patient showed no response to the treatments for PTS. He was diagnosed with RSD according to the clinical findings. The bone scan confirmed the diagnosis. He responded well to the physical therapy and therapeutic exercises program. RSD and PTS are the two conditions having some common features and resembling clinical pictures. RSD also should be kept in mind in differential diagnosis of patients who developed limb pain and edema after DVT. There are some different points in the characteristics of the common symptoms obtained in both of the clinical conditions. Bone scan can help to confirm the diagnosis if RSD is suspected. Because the treatments of two conditions are different, making the differential diagnosis is crucial.
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PMID:Reflex sympathetic dystrophy secondary to deep venous thrombosis mimicking post-thrombotic syndrome. 1936 11

A 21-year-old female with right distal femoral pedunculated osteochondroma is presented. She was admitted for severe lower limb pain, and swelling of one week duration. Clinical findings supported deep vein thrombosis (DVT) but Doppler ultrasound, and venography were normal. Surgical exploration revealed a large bursa around the tumor with a big vein abraded and thrombosed inside the bursa.
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PMID:Intrabursal vein abrasion and thrombosis. An unusual complication of femoral osteochondroma. 1993 29

Although usually considered a disease of sedentary people, deep venous thrombosis can occur in active patients. Physical findings may be difficult to differentiate from those of muscle trauma, a Baker's cyst, or hematoma. A high index of suspicion must be maintained, because delay in making the diagnosis and initiating anticoagulation may have fatal consequences. Doppler flow studies are required in all cases of limb pain or swelling in runners when deep venous thrombosis is even remotely suspected, as in this case of a 40-year-old man who developed ankle and lower-leg pain 1 month after a 10-km run. If promptly treated, patients can make a safe return to training without adverse consequences.
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PMID:Extensive venous thrombosis in a runner: progression of symptoms key to diagnosis. 2008 31

Patients often present with unexplained lower limb pain and swelling. It is important to exclude deep venous thrombosis in the diagnosis because of the threat of sudden death. Simple clinical diagnosis is unacceptable, and noninvasive tests should be used initially. Serial testing detects proximal extension of isolated calf thrombi. Multiple diagnostic modalities are employed to diagnose a new deep venous thrombosis in patients with postphlebitic syndrome.
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PMID:Diagnosing Deep Venous Thrombosis: Use of tests for accurate diagnosis. 2122 69

We present the case of a fit and well 20-year-old gentleman who presented to our emergency department with unilateral lower limb pain and swelling. Subsequent imaging revealed a left ilio-femoral deep vein thrombosis, with associated duplication of his inferior vena cava. He was treated conservatively with a heparin infusion, warfarin and compression therapy prior to being discharged following a short inpatient stay.
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PMID:Duplicated inferior vena cava with associated ilio-femoral deep vein thrombosis. 2279 21


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