Congenital anomaly of the inferior vena cava and factor V Leiden mutation predisposing to deep vein thrombosis.
Humans; Male; Young Adult; Ultrasonography; *Mutation; Risk Factors; Predictive Value of Tests; Genetic Predisposition to Disease; Activated Protein C Resistance/*complications/diagnosis/drug therapy/genetics; Anticoagulants/therapeutic use; deep vein thrombosis (DVT); DNA Mutational Analysis; Factor V/*genetics; inferior vena cava (IVC); lower extremities; Phlebography/methods; thrombophilic; Vascular Malformations/*complications/diagnosis; venography; Venous Thrombosis/diagnosis/drug therapy/*etiology/genetics; Mutation; Tomography; Human; X-Ray Computed; Sequence Analysis; Vena Cava; Inferior/*abnormalities/diagnostic imaging; Venous Thrombosis; Blood Coagulation Factors; Disease Susceptibility; Hematologic Diseases; Venous Thrombosis – Drug Therapy; Anticoagulants – Therapeutic Use; Hematologic Diseases – Complications; Hematologic Diseases – Diagnosis; Hematologic Diseases – Drug Therapy; Inferior – Abnormalities; Inferior – Radiography; Inferior – Ultrasonography; Phlebography – Methods; Vascular Malformations – Complications; Vascular Malformations – Diagnosis; Venous Thrombosis – Diagnosis; Venous Thrombosis – Etiology
A previously healthy 21-year-old man presented with back pain, bilateral extremity pain, and right lower extremity weakness, paresthesias, and swelling. Sonographic examination revealed diffuse deep vein thrombosis (DVT) in the femoral and popliteal venous system. CT imaging revealed hypoplasia of the hepatic inferior vena cava (IVC) segment with formation of multiple varices and collateral veins around the kidneys. Hematologic workup also discovered a factor V Leiden mutation, further predisposing the patient to DVT. The rare, often overlooked occurrence of attenuated IVC, especially in the setting of hypercoagulable state, can predispose patients to significant thrombosis.
Lamparello Brooke M; Erickson Cameron R; Kulthia Arun; Virparia Vasudev; Thet Zeyar
Vascular Health and Risk Management
2014
1905-07
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2147/vhrm.s66283" target="_blank" rel="noreferrer noopener">10.2147/vhrm.s66283</a>
No correlation between lower extremity deep vein thrombosis and pulmonary embolism proportions in trauma: a systematic literature review.
Chemoprophylaxis; Chi Square Test; Deep vein thrombosis; Disease Surveillance – Evaluation; Emergency Patients; Fisher's Exact Test; Human; Lower Extremity – Pathology; Mechanical prophylaxis; PubMed; Pulmonary embolism; Pulmonary Embolism – Drug Therapy; Systematic Review; Ultrasound surveillance; Venous thromboembolism; Venous Thrombosis – Drug Therapy
PURPOSE: To assess the effect of surveillance on deep vein thrombosis (DVT) and pulmonary embolism (PE) rates, the efficacy of chemoprophylaxis and mechanical prophylaxis, and the relationship between DVT and PE. METHODS: A 23 year, systematic literature review was performed in PubMed. Twenty publications with \textgreater 13,000 patients were reviewed. Analyzed traits included: DVT surveillance utilization, the total number of patients included in each study, the number of patients developing DVT and/or PE, chemoprophylaxis and mechanical prophylaxis utilization. When event proportions from individual studies were combined, a weighted mean proportion was computed based on the size of each individual cohort. Combined event proportions were compared with other combined event proportions, according to differences in intervention. Inter-group event proportions were compared using Chi-Square or Fisher's exact test, as appropriate. RESULTS: DVT rates increase with surveillance (10.7% vs. 2.5%, p \textless 0.001). PE rates were similar regardless of surveillance (p = 1.0). Chemoprophylaxis lowered both DVT rates (8.2% vs. 10.7%; p \textless 0.0001) and PE rates (1.2% vs. 1.9%; p = 0.0050). Mechanical prophylaxis did not decrease DVT rates (10.2% vs. 11.5%; p = 0.2980) or PE rates (1.7% vs. 1.6%; p = 1.0). In patients with neither chemoprophylaxis nor mechanical prophylaxis, DVT rate was 11.5%, PE was 1.6%. When chemoprophylaxis and/or mechanical prophylaxis were given, DVT rate was 8.6% (p \textless 0.0189) and PE was 1.3% (p = 0.4462). PE proportions were not decreased with mechanical prophylaxis or surveillance. DVT and PE rates were not associated (p = 0.7574). CONCLUSIONS: The results suggest that PE is not associated with lower extremity DVT in adult trauma patients.
Aziz Hiba Abdel; Hileman Barbara M; Chance Elisha A
European journal of trauma and emergency surgery : official publication of the European Trauma Society
2018
2018-12
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s00068-018-1043-3" target="_blank" rel="noreferrer noopener">10.1007/s00068-018-1043-3</a>