Deep vein thrombosis.
نویسنده
چکیده
The classical presentation of deep vein thrombosis (DVT) is sudden onset of pain, redness, and swelling of one leg spreading from the calf to the thigh with marked swelling of the dorsum of the foot and tenderness along the deep venous system. The more severe condition of ileofemoral thrombophlebitis can result in marked swelling and femoral arterial occlusion (plegmasia dolora albus). Fortunately, this condition is rare, but must be recognised early as emergency thrombectomy can save the limb. Marked venous thrombosis can cause swelling/haemorrhage in compartments of the lower limbs resulting in the absence of an arterial pulse and requiring urgent surgical decompression. Equally, DVT can be completely silent, with the first manifestation being a massive pulmonary embolism causing sudden death. Submassive pulmonary embolism presents with chest pain and severe dyspnoea, while branch arterial emboli may present with pneumonic changes or pleural effusion. Repeated minor embolisms from silent thrombi in the legs or pelvis present with progressive pulmonary hypertension and decreased exercise tolerance. The differential diagnoses of swelling in one leg are many, and include cellulitis, lymphangitis, gout, arthritis, and ruptured Baker’s cyst in the knee. In fact, DVT is clinically misdiagnosed in approximately half of all patients with pain and swelling in one leg. Modern imaging techniques have, however, increased the sensitivity and specificity to more than 90%.
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ورودعنوان ژورنال:
- Hong Kong medical journal = Xianggang yi xue za zhi
دوره 8 6 شماره
صفحات -
تاریخ انتشار 2002