3. It is semisolid clot in the vein which has got
high tendency to develop pulmonary embolism and
sudden death.
Common site of beginning of thrombosis is
soleal veins which propogate proximally ,ofen
getting detached to cause acute massive pulmonary
embolism or moderate sized emboli can cause
pyramidal/wedge shaped pulmonary infarcts.
4. AETIOLOGY-FACTORS
• Following child birth
• Trauma-to leg,ankle,thigh,pelvis
• Muscular violence
• Immobility:Bed ridden patients,individuals on long
duration air or bus travel(Traveller’s thrombosis)
• Debilitating illness ,obesity,immobility,bed rest,
pregnancy,oral contraceptives,estrogens
Most common cause: Post operative Thrombosis
In 30% of cases both legs are affected.Usually
seen after prostate,hip,major abdominal,gynaecological,
cancer surgeries.Bed ridden for more than 3 days in
Post operative period increases risk of DVT
5. SITES
• Pelvic vein
• Leg veins
• Upper limb veins
PHLEGMASIA ALBA DOLENS [WHITE LEG]
DVT of femoral vein ( deep femoral vein commonly ) causing
painful congestion and edema of leg, with lymphangitis
PHLEGMASIA CAERULEA DOLENS
Extensive DVT of iliac and pelvic veins causing blue leg with
either venous
Gangrene or areas of infarction
6.
7.
8. CLINICAL FEATURES
SYMPTOMS
Most often asymptomatic and presents suddenly
with features of pulmonary embolism
like chest pain ,breathlessness,hemoptysis
• Fever-earliest symptom
• Pain and swelling in calf and thigh
• Leg is tense ,tender,warm,pale or bluish with
stretched and shiny skin
9. SIGNS
• Positive Homan’s sign :
passive forceful dorsiflexion of foot with extended
knee will cause tenderness in the calf
• Moses sign
Gentle squeeing of lower part of calf from
side to side is painful
10.
11. NEUHOF’S SIGN
Thickening and deep tenderness elicted while palpating deep
in calf muscles
LINTON’S TEST
After applying tourniquet at sapheno-femoral junction patient is
made to walk with out removing it, limb is elevated-persisiing
prominent superficial veins will observesd in DVT
12. VENOUS DOPPLER
DUPLEX SCANNING
shows noncompressible vein-wider than
normal
on compression –doesnot show any
augmentation of flow
normal venous sound at the area of femoral
vein which disappeara during inspiration is
conspicuously absent in DVT
13.
14. VENOGRAM
contrast material injected to venous system
after applying to superficial system
occlusive and non occlusive thrombosis are
dffrentiated
it is an invasive technique
15. PHLEBOGRAPHY
Patient lies on a mobile table in horizontal
position
45% sodium ditriazolate is injected slowly into
a vein on dorsum of great toe
the findings are rwecorded by observing the
flow of contrast mediumas viewed on
tekivision screen
16. HAEMOGRAM WITH PLATELET COUNT
D-dimer test/analysis of fibrin degradation
product(FDP) are relevantly used
17. Rest,elevation of limb,bandaging the entire
limb with crepe bandage
Anticoagulants: heparin/low mol wt
heparin,warfarin,phenindiope
18.
19. Care- for proper positioning of legs with no
pressure on calf muscle
Pressure bandages to legs have to be applied
during major surgeries,laproscopic
surgeries,during post op period, elevation,
,hydration are essential measures
Low dose heparin is given in suspected case
Smoking increases viscosity of bloods
