RT Book, Section
A1 Gomes, Marcelo P. Villa-Forte
A2 Dean, Steven M.
A2 Satiani, Bhagwan
A2 Abraham, William T.
SR Print(0)
ID 1105291323
T1 MEDICAL MANAGEMENT OF FEMOROPOPLITEAL DEEP VENOUS THROMBOSIS
T2 Color Atlas and Synopsis of Vascular Diseases
YR 2015
FD 2015
PB McGraw-Hill Medical
PP New York, NY
SN 9780071749541
LK accesssurgery.mhmedical.com/content.aspx?aid=1105291323
RD 2024/04/20
AB A  44-year-old  Caucasian  woman  presented  to  the  emergency  department  with  a  2-week-history  of  right-leg  pain  and  edema  involving  the  lower  thigh  to  the  ankle.  One  week  prior  to  her  emergency  room  visit,  she  developed  increasing  fatigue  associated  with  pleuritic  chest  pain,  exertional  dyspnea,  and  palpitations.  Her  leg  symptoms  began  within  2  weeks  after  she  was  discharged  from  the  hospital  after  undergoing  a  4-day  stay  for  surgery  for  breast  cancer.  Her  medical  history  is  significant  for  vasculitis  (granulomatosis  with  polyangiitis/Wegener  granulomatosis)  and  mild  iron  deficiency  anemia.  She  stopped  taking  a  birth  control  pill  a  few  weeks  prior  to  surgery.  Physical  examination  demonstrates  blood  pressure  of  138/68  mm  Hg,  heart  rate  of  102  bpm,  body  mass  index  of  34,  regular  heart  rate  and  rhythm,  and  lungs  clear  to  auscultation.  The  right  lower  extremity  has  soft  pitting  edema  with  negative  Homan  sign.  There  is  no  cyanosis  in  the  extremities,  and  distal  lower  extremity  pulses  are  intact  and  symmetrical.  Acute  deep  venous  thrombosis  (DVT)  is  suspected.  The  quantitative  D-dimer  level  is  1200  mg/dL,  and  a  venous  duplex  ultrasound  reveals  acute  DVT  involving  the  common  femoral  (Figure  53-1),  femoral,  and  popliteal  veins.