scholarly journals Diabetic muscle infarction with pelvic vein thrombosis - An uncommon presentation to the Emergency Department

2016 ◽  
Vol 2016 (2) ◽  
pp. 111
Author(s):  
Suresh Varadarajulu ◽  
Sameer Pathan
Keyword(s):  
Emergency Department ◽  
Pelvic Vein ◽  
Vein Thrombosis ◽  
Muscle Infarction ◽  
Uncommon Presentation

scholarly journals Postmortem Demonstration of the Source of Pulmonary Thromboembolism: The Importance of the Autopsy

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Gina Elhammady ◽  
Andrew T. Schubeck ◽  
Vicky El-Najjar ◽  
Morton J. Robinson
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Thromboembolism ◽  
Postmortem Examination ◽  
Pelvic Vein ◽  
Vein Thrombosis ◽  
Potential Source ◽  
Venous Thromboses

Periprostatic or paravaginal venous thromboses are rarely considered clinically as sites of clot origin in patients with pulmonary thromboembolism. The majority of emboli have been demonstrated to originate in the veins of the legs. This report raises awareness of pelvic vein thrombosis as a potential source of pulmonary embolism that is rarely considered or detected clinically, and which usually requires postmortem examination for recognition. It also reviews the possible routes emboli may take to reach the lungs.

scholarly journals Anticoagulant therapies for acute venous thromboembolism: a comparison between those discharged directly from the emergency department versus hospital in two Canadian cities

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e022063 ◽  
Author(s):  
Tammy J Bungard ◽  
Bruce Ritchie ◽  
Jennifer Bolt ◽  
William M Semchuk
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Venous Thromboembolism ◽  
Severity Index ◽  
Vein Thrombosis ◽  
Risk Patients ◽  
Acute Venous Thromboembolism ◽  
Record Review ◽  
Deep Vein

ObjectiveTo compare the characteristics/management of acute venous thromboembolism (VTE) for patients either discharged directly from the emergency department (ED) or hospitalised throughout a year within two urban cities in Canada.DesignRetrospective medical record review.SettingHospitals in Edmonton, Alberta (n=4) and Regina, Saskatchewan (n=2) from April 2014 to March 2015.ParticipantsAll patients discharged from the ED or hospital with acute deep vein thrombosis or pulmonary embolism (PE). Those having another indication for anticoagulant therapy, pregnant/breast feeding or anticipated lifespan <3 months were excluded.Primary and secondary outcomesPrimarily, to compare proportion of patients receiving traditional therapy (parenteral anticoagulant±warfarin) relative to a direct oral anticoagulant (DOAC) between the two cohorts. Secondarily, to assess differences with therapy selected based on clot burden and follow-up plans postdischarge.Results387 (25.2%) and 665 (72.5%) patients from the ED and hospital cohorts, respectively, were included. Compared with the ED cohort, those hospitalised were older (57.3 and 64.5 years; p<0.0001), more likely to have PE (35.7% vs 83.8%) with a simplified Pulmonary Embolism Severity Index (sPESI) ≥1 (31.2% vs 65.2%), cancer (14.7% and 22.3%; p=0.003) and pulmonary disease (10.1% and 20.6%; p<0.0001). For the ED and hospital cohorts, similar proportions of patients were prescribed traditional therapies (72.6% and 71.1%) and a DOAC (25.8% and 27.4%, respectively). For the ED cohort, DOAC use was similar between those with a sPESI score of 0 and ≥1 (35.1% and 34.9%, p=0.98) whereas for those hospitalised lower risk patients were more likely to receive a DOAC (31.4% and 23.8%, p<0.055). Follow-up was most common with family physicians for those hospitalised (51.5%), while specialists/VTE clinic was most common for those directly discharged from the ED (50.6%).ConclusionsTraditional and DOAC therapies were proportionately similar between the ED and hospitalised cohorts, despite clear differences in patient populations and follow-up patterns in the community.

Internal jugular vein thrombosis: an uncommon presentation

Vascular ◽  
2013 ◽  
Vol 21 (4) ◽  
pp. 267-269 ◽  
Author(s):  
Sachin Mittal ◽  
Pradeep Garg ◽  
Surender Verma ◽  
Sandeep Bhoriwal ◽  
Sourabh Aggarwal
Keyword(s):  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Sinus Thrombosis ◽  
Color Doppler ◽  
Venous Catheter ◽  
Neck Surgery ◽  
Jugular Vein Thrombosis ◽  
Vein Thrombosis ◽  
Uncommon Presentation ◽  
Internal Jugular Vein Thrombosis

Internal jugular vein (IJV) thrombosis is a rare entity. It is usually secondary to various etiologies such as ovarian hyperstimulation, deep vein thrombosis of upper limbs, venous catheter, malignancy, trauma, infection, and neck surgery and hypercoagulable status. We report an unusual case of internal jugular vein thrombosis with cerebral sinus thrombosis, postpartum in a 22-year-old female patient who presented with a painful swelling on the left side of her neck. Diagnosis was established by color Doppler ultrasonography and magnetic resonance venography. Thorough evaluation of the patient revealed no etiological factor leading to thrombosis. Patient was treated with low-molecular-weight heparin.

scholarly journals Heparin-induced thrombocytopenia presenting as splenic hemorrhage following cardiac surgery: a case report

2020 ◽  
Author(s):  
Joseph F. Ferry ◽  
Samuel Youssef ◽  
Pierce Wu ◽  
Livia Hegerova
Keyword(s):  
Emergency Department ◽  
Cardiac Surgery ◽  
Splenic Vein ◽  
Adrenal Hemorrhage ◽  
Right Atrial ◽  
Splenic Vein Thrombosis ◽  
Heparin Induced Thrombocytopenia ◽  
Vein Thrombosis ◽  
Bilateral Adrenal Hemorrhage ◽  
The Right

Abstract Background: Heparin-induced thrombocytopenia with thrombosis (HITT) is a paradoxical prothrombotic complication of anticoagulant therapy. As many as 3% of patients undergoing cardiac surgery develop clinical HIT presenting as thrombocytopenia with or without thrombosis within 5-10 days of heparin exposure. Thrombotic complications associated with HIT carry a mortality rate of 5-10%.Case presentation: We report a case of atraumatic splenic hemorrhage due to splenic vein thrombosis as the main indicator of HIT following cardiac surgery in a 62-year-old woman. She presented to the emergency department on day nine following coronary artery bypass graft surgery with acute weakness, dizziness, and malaise. Her evaluation in the emergency department found anemia and thrombocytopenia. A coagulation profile revealed a markedly elevated d-dimer. She underwent a computed tomography scan of the chest, abdomen and pelvis for suspected bleed and was found to have splenic vein thrombosis, right atrial filling defects consistent with atrial thrombus and mild to moderate hemoperitoneum. Surgical consultation was obtained due to splenic hemorrhage. Hematology was consulted on post-operative day 10, however, she unfortunately developed left sided weakness concerning for stroke. A magnetic resonance imaging scan of the brain demonstrated infarct involving distribution of the right anterior cerebral artery. A transesophageal echocardiogram demonstrated a large immobile thrombus within the right atrium with a second, mobile thrombus arising from the left tricuspid valve annulus. Due to a 4Ts score of 7 and markedly positive platelet factor 4 (PF4) IgG antibody a serotonin release assay was not performed given the high probability of HIT. She was cautiously treated with bivalirudin and was transitioned to warfarin anticoagulation. In the following days her platelet count recovered and 3 months later a transthoracic echocardiogram revealed solution of the intracardiac thrombi.Conclusions: Atraumatic splenic hemorrhage is an unusual presentation of HIT that is reminiscent of the rare bilateral adrenal hemorrhage due to adrenal necrosis that also occurs in HIT. Alternative anticoagulation is the mainstay of therapy for HIT despite hemorrhage, given the underlying acquired hypercoagulability. Despite similarities of the presentation between splenic hemorrhage and bilateral adrenal hemorrhage, splenic hemorrhage is rarely described in the literature. HIT should be considered in patients presenting with thrombocytopenia following cardiac surgery.

scholarly journals Heparin-induced thrombocytopenia presenting as splenic hemorrhage following cardiac surgery: a case report

2020 ◽  
Author(s):  
Joseph Frank Ferry ◽  
Samuel Youssef ◽  
Pierce Wu ◽  
Livia Hegerova
Keyword(s):  
Emergency Department ◽  
Cardiac Surgery ◽  
Splenic Vein ◽  
Adrenal Hemorrhage ◽  
Right Atrial ◽  
Splenic Vein Thrombosis ◽  
Heparin Induced Thrombocytopenia ◽  
Vein Thrombosis ◽  
Bilateral Adrenal Hemorrhage ◽  
The Right

Abstract Background Heparin-induced thrombocytopenia with thrombosis (HITT) is a paradoxical prothrombotic complication of anticoagulant therapy. As many as 3% of patients undergoing cardiac surgery develop clinical HIT presenting as thrombocytopenia with or without thrombosis within 5–10 days of heparin exposure. Thrombotic complications associated with HIT carry a mortality rate of 5–10%. Case presentation: We report a case of atraumatic splenic hemorrhage due to splenic vein thrombosis as the main indicator of HIT following cardiac surgery in a 62-year-old woman. She presented to the emergency department with acute weakness, dizziness, and malaise. Her evaluation in the emergency department found anemia and thrombocytopenia. A coagulation profile revealed a markedly elevated d-dimer. She underwent a computed tomography scan of the chest, abdomen and pelvis for suspected bleed and was found to have splenic vein thrombosis, right atrial filling defects consistent with atrial thrombus and mild to moderate hemoperitoneum. Surgical consultation was obtained due to splenic hemorrhage. Hematology was consulted on post-operative day 10, however, she unfortunately developed left sided weakness concerning for stroke. A magnetic resonance imaging scan of the brain demonstrated infarct involving distribution of the right anterior cerebral artery. A transesophageal echocardiogram demonstrated a large immobile thrombus within the right atrium with a second, mobile thrombus arising from the left tricuspid valve annulus. Due to a 4Ts score of 7 and markedly positive platelet factor 4 (PF4) IgG antibody a serotonin release assay was not performed given the high probability of HIT. She was cautiously treated with bivalirudin and was transitioned to warfarin anticoagulation. In the following days her platelet count recovered and 3 months later a transthoracic echocardiogram revealed solution of the intracardiac thrombi. Conclusions Atraumatic splenic hemorrhage is an unusual presentation of HIT that is reminiscent of the rare bilateral adrenal hemorrhage due to adrenal necrosis that also occurs in HIT. Alternative anticoagulation is the mainstay of therapy for HIT despite hemorrhage, given the underlying acquired hypercoagulability. Despite similarities of the presentation between splenic hemorrhage and bilateral adrenal hemorrhage, splenic hemorrhage is rarely described in the literature. HIT should be considered in patients presenting with thrombocytopenia following cardiac surgery.

scholarly journals Accuracy of three-point compression ultrasound for the diagnosis of proximal deep-vein thrombosis in emergency department

2019 ◽  
Vol 24 (1) ◽  
pp. 80 ◽  
Author(s):  
RaziehSadat Mousavi-Roknabadi ◽  
Afsaneh Dehbozorgi ◽  
Fatemeh Damghani ◽  
Mehrdad Sharifi ◽  
SeyedMahmoudreza Sajjadi ◽  
...  
Keyword(s):  
Emergency Department ◽  
Deep Vein Thrombosis ◽  
Proximal Deep Vein Thrombosis ◽  
Vein Thrombosis ◽  
Compression Ultrasound ◽  
Point Compression ◽  
Deep Vein

scholarly journals A Case Report on VT from TV: DVT and PE from Prolonged Television Watching

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alan Lucerna ◽  
James Espinosa ◽  
Lindsey Ackley ◽  
Philip Carhart ◽  
Douglas Stranges ◽  
...  
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Deep Vein Thrombosis ◽  
Case Report ◽  
Pulmonary Embolus ◽  
Thromboembolic Events ◽  
Television Watching ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Made In

Pulmonary embolus (PE) and deep vein thrombosis are diagnoses that are commonly made in the emergency department. Well known risk factors for thromboembolic events include immobility, malignancy, pregnancy, surgery, and acquired or inherited thrombophilias, obesity, cigarette smoking, and hypertension. We present a case of a 59-year-old female who watched TV and developed leg swelling and was found to have PE and DVT.

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