1/45. thrombophlebitis and pulmonary embolism with surgical intervention in the third trimester.A case of acute deep vein thrombophlebitis and pulmonary embolism in late gestation has been presented with a discussion of diagnostic modalities, therapeutic regimens, and theoretical considerations. It is our belief that aggressive medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is best accomplished by giving heparin intravenously as the primary anticoagulant. When medical management is not effective or if embolism occurs, surgical intervention, consisting of vena caval clipping and ovarian vein ligation with scrupulous attention to detail, is indicated. Further, support to prophylaxis of abruptio placenta secondary to the mechanism espoused by Mengert et al is added by the course of this patient.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
2/45. A case report of acute pelvic thrombophlebitis missed by magnetic resonance imaging of the pelvic veins.A 29-year-old woman presented post-natally with pulmonary hypertension. Peripheral venous thrombosis was not detected by duplex ultrasound or conventional MRI. Despite anticoagulation, the patient arrested. autopsy revealed right iliac vein thrombosis. The ability of conventional MRI to detect acute pelvic thrombophlebitis depends on obtaining appropriate views.- - - - - - - - - - ranking = 5keywords = thrombophlebitis (Clic here for more details about this article) |
3/45. heparin prophylaxis for deep venous thrombosis in a patient with multiple injuries: an evidence-based approach to a clinical problem.OBJECTIVE: To demonstrate a clinical decision-making process by which to determine if heparin prophylaxis for deep venous thrombosis (DVT) is appropriate in a specific patient with multiple injuries. DATA SOURCES: A medline search of the literature. Search terms included trauma, heparin, deep venous thrombosis, thrombophlebitis, phlebitis, and trauma. STUDY SELECTION: Eleven studies were selected from 789 publications using published criteria. incidence, risk and potential for prophylaxis were established through a structured review process. DATA EXTRACTION: After the structured review, a small number of studies were available for the consideration of incidence (2), natural history (4) and prophylactic therapy (2). DATA SYNTHESIS: The incidence of DVT in a patient with such multiple injuries is significant (58%-63%). The resulting risk of pulmonary embolism was 4.3% with an associated 20% death rate. Prophylaxis with low molecular weight heparin is associated with a statistically and clinically significant risk reduction for DVT when compared with unfractionated heparin and untreated controls. CONCLUSIONS: Few of the multiple available studies concerning trauma, DVT and pulmonary embolism meet reasonable standards to establish clinical validity. Available guidelines for literature evaluation allow surgeons to select relevant articles for consideration. patients with multiple trauma appear to be at significant risk for DVT. The death rate associated with subsequent pulmonary embolism is significant. There is reasonably good evidence to suggest that low molecular weight heparin will reduce this likelihood without a significant risk of treatment complications.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
4/45. Recurrent thrombophlebitis and pulmonary emboli in congenital factor 5 deficiency.A case of congenital coagulation factor 5 deficiency is reported. Despite this defect in blood coagulation, this patient had frequent episodes of thrombophlebitis which were associated with pulmonary emboli on two occasions. Heparinization caused no hemorrhagic complications.- - - - - - - - - - ranking = 5keywords = thrombophlebitis (Clic here for more details about this article) |
5/45. Chronic thromboembolic occlusion of main pulmonary artery or primary branches. Case report and review of the literature.Chronic thromboembolic occlusion of the left pulmonary artery in a 36 year old woman is described, and similar cases reported in the past 15 years are discussed. On review, this disease remains a rare entity. In the majority of cases, the etiology is thrombophlebitis and acute pulmonary embolism. Associated cardiopulmonary disease is uncommon. The most common presenting symptom is unexplained dyspnea, and the majority of patients have past histories of hemoptysis. Acute cardiovascular collapse is distinctly rare. Most physical signs and laboratory tests are normal or nonspecific. The perfusion lung scan, although nonspecific, is the best screening test. Antemortem diagnosis, with rare exception, is established by pulmonary angiography. Eleven patients have been operated on: thromboembolectomy in nine, saphenous vein graft in one and pneumonectomy in one. Operative mortality was 36 per cent (four of 11), definite improvement was seen in 46 per cent (five of 11), and 18 per cent (two of 11) survived the operation with no improvement. The role of medical therapy in this disease is considered.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
6/45. Pulmonary thromboembolism. Evaluating the indication and effect of a vena caval filter with indium-111-platelet scintigraphy.A 63-year-old woman complained of chest pain and was referred to hospital where she was found to have left pleural effusion and swelling, local heat and edema of the right lower leg. Initial pulmonary perfusion scintigraphy demonstrated multiple defects and pulmonary thromboembolism (PTE) was confirmed during the anticoagulant and thrombolytic therapy against thrombophlebitis. A Greenfield filter was inserted in the inferior vena cava to prevent recurrence of PTE from the thrombosis that was resistant to therapy. In-111-labeled platelet scintigraphy (platelet scintigraphy) showed abnormal uptake of platelets in the chest, femoral veins and abdomen, which suggested active thrombus formation in those regions, including the filter, and a risk of recurrent PTE. Therefore, the thrombolytic therapy was terminated and the anticoagulant therapy intensified. A computed tomography (CT) scan revealed thrombus at the filter, which was markedly decreased 1 month later on platelet scintigraphy. pulmonary ventilation and perfusion scintigraphy revealed remarkable improvement of the PTE. In this case, platelet scintigraphy complemented CT in demonstrating the activity and localization of the thrombus and can be used to evaluate the risk of recurrence during thrombolytic therapy after insertion of a filter.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
7/45. Laparoscopic procedures as a risk factor of deep venous thrombosis, superficial ascending thrombophlebitis and pulmonary embolism--case report and review of the literature.Since its introduction laparoscopic surgery has been used for many indications, e.g., cholecystolithiasis, hernia, appendicitis, fundoplication, benign large bowel disease and gynaecological disorders. It has been considered as safe and efficient procedure for most patients with only few contraindications, mostly heart-lung disease. When the initial enthusiasm has been replaced by a more critical observation, more complications of laparoscopy or laparoscopic surgery were not only discovered but also reported. In laparoscopic hernia repair there is a tendency for severe complications when compared to open surgery. There is a controversy on possible side-effects of laparoscopic surgery, e.g., thrombosis, and the increased necessity of prophylaxis for thromboembolic events. Recently a growing number of reports on thromboembolic complications in association with laparoscopic surgery were published. Thrombosis may be caused by detrimental effects of pneumoperitoneum on venous flow (increased abdominal pressure and negative Trendelenburg position) and activation of the haemostatic system. Further risk factors may contribute to the risk to develop venous thrombosis. It is well accepted that varicose veins are associated with an increased risk for the thrombosis. However, the association of varicose veins with complications of laparoscopic surgery is unclear. The possible impact of thrombotic complications makes an analysis of the association of varicose veins or a history of deep vein thrombosis on the development of thrombosis after laparoscopic surgery mandatory. Although this is the first report on ascending thrombophlebitis and thrombosis of the sapheno-femoral junction after laparoscopic surgery, the incidence of deep vein thrombosis or superficial thrombophlebitis after laparoscopic surgery or laparoscopy may be much higher according to the pathophysiological changes during and after these procedures. In many patients venous thrombosis may not be recognized or it appears when the patient is already discharged. CONCLUSION: laparoscopy and laparoscopic procedures may have an increased risk for the development of thrombosis due to increased abdominal pressure and negative Trendelenburg position. patients with varicose veins and a history of thromboembolism may aggravate laparoscopy associated risks for the development of thromboembolic complications. Superficial thrombophlebitis in the thigh is not a benign disease entity and may lead to deep vein thrombosis (DVT) and pulmonary embolism (PE). Urgent surgical treatment (high ligation) may be warranted together with low-molecular weight heparin (LMWH) and compressions therapy. patients with varicose veins and a history of venous thrombosis may not be suitable candidates for laparoscopic surgery. family practitioners may be confronted with this complication more often since patients are discharged earlier from hospital after laparoscopic interventions due to legislative regulations.- - - - - - - - - - ranking = 7keywords = thrombophlebitis (Clic here for more details about this article) |
8/45. Lemierre's syndrome: porphyromonas asaccharolytica as a putative pathogen.A case of Lemierre's syndrome is reported in which metastatic abscesses resulted from septic thrombophlebitis of the internal jugular vein secondary to bacterial pharyngitis. A 32-year-old male suffering from a painful left-sided neck mass, sore throat, and fever was admitted to our hospital. Computed tomography revealed thrombosis of the left internal jugular vein, septic pulmonary emboli, and a liver abscess. Blood culture showed porphyromonas asaccharolytica. Although empyema occurred transiently during the treatment, the patient recovered following prolonged antimicrobial therapy. Although fusobacterium species are a well-known cause of Lemierre's syndrome, cases in whom porphyromonas species was isolated have scarcely been reported. Moreover, case reports from japan have been few.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
9/45. Endoluminal recanalization in a patient with phlegmasia cerulea dolens using a multimodality approach-a case report.Phlegmasia cerulea dolens is a limb-threatening form of deep venous thrombosis and should be treated aggressively. The authors report a patient who presented with iliocaval and femoral deep venous thrombosis and posed an additional therapeutic challenge based on a recent history of heparin-induced thrombocytopenia. Catheter-directed pharmacologic thrombolysis and balloon venoplasty were applied in treatment. The direct thrombin inhibitor argatroban was used in place of heparin for concurrent anticoagulation. This multimodality endovascular approach (chemical and mechanical interventions) was successful in relieving the venous occlusion and salvaging the limb, while maintaining appropriate treatment for heparin-induced thrombocytopenia.- - - - - - - - - - ranking = 9.5169818886911keywords = phlegmasia, dolens (Clic here for more details about this article) |
10/45. pulmonary embolism and deep jugular venous thrombosis resulting from compression by a lipoma.Lipomas usually extend in subcutaneous tissues and rarely may be compressive. We report a case of neck lipoma resulting in jugular vein thrombosis and pulmonary embolism in a patient treated by clozapine. Clozpine may be considered an associated risk factor for thrombosis. This case suggests that performing a regional evaluation may be particularly important when thrombophlebitis occurs.- - - - - - - - - - ranking = 1keywords = thrombophlebitis (Clic here for more details about this article) |
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