Thrombolysis of an extensive venous thrombosis of the lower body in an anomaly of the vena cava inferior
HISTORY AND CLINICAL FINDINGS: A 41-year-old man was admitted to hospital for acute pain in the right flank. At first urolithiasis was suspected but excluded by sonography and excretion urography. Computed tomography (CT) was performed because of increasing pain and swelling of the left leg. It showed bilateral thrombosis of the deep leg and pelvic veins as well as of the infrarenal inferior vena cava (IVC) and the right renal vein. The patient's general condition was impaired. The circumference of the left leg was greater than that of the right by 5 cm 15 cm above the knee joint space and both legs had marked varicosities with congestive dermatitis.
INVESTIGATIONS: The concentration of the thrombin-antithrombin complex was 13.4 micrograms/l, D-dimer 124 micrograms/l, prothrombin fragment F1+2 3,5 nmol/l and fibrin monomere 27.7 micrograms/ml, as expression of a manifest thrombosis. CT with contrast medium demonstrated the previously sonographically shown extent of the thrombosis. In addition the hepatic IVC segment was absent. The azygos vein was enlarged and there was an extensive collateral circulation.
TREATMENT AND COURSE: Systemic thrombolysis (streptokinase for 3 days, then urokinase) for 11 days dissolved the thrombi and CT now demonstrated complete recanalization of the caudal deep vein system and the IVC abnormality (absence of hepatic segment). After intravenous thrombolysis oral anticoagulation with phenprocoumon was started and will be continued all the patient's life.
| Medienart: |
Artikel |
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| Erscheinungsjahr: |
1996 |
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| Erschienen: |
1996 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:121 |
|---|---|
| Enthalten in: |
Deutsche medizinische Wochenschrift (1946) - 121(1996), 5 vom: 02. Feb., Seite 124-8 |
| Sprache: |
Deutsch |
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| Weiterer Titel: |
Thrombolyse einer ausgedehnten Venenthrombose der unteren Körperhälfte bei Anomalie der Vena cava inferior |
|---|
| Beteiligte Personen: |
Rühlmann, C [VerfasserIn] |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 09.10.1996 Date Revised 21.11.2008 published: Print Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM086892231 |
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| 100 | 1 | |a Rühlmann, C |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Thrombolysis of an extensive venous thrombosis of the lower body in an anomaly of the vena cava inferior |
| 246 | 3 | 3 | |a Thrombolyse einer ausgedehnten Venenthrombose der unteren Körperhälfte bei Anomalie der Vena cava inferior |
| 264 | 1 | |c 1996 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ohne Hilfsmittel zu benutzen |b n |2 rdamedia | ||
| 338 | |a Band |b nc |2 rdacarrier | ||
| 500 | |a Date Completed 09.10.1996 | ||
| 500 | |a Date Revised 21.11.2008 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a HISTORY AND CLINICAL FINDINGS: A 41-year-old man was admitted to hospital for acute pain in the right flank. At first urolithiasis was suspected but excluded by sonography and excretion urography. Computed tomography (CT) was performed because of increasing pain and swelling of the left leg. It showed bilateral thrombosis of the deep leg and pelvic veins as well as of the infrarenal inferior vena cava (IVC) and the right renal vein. The patient's general condition was impaired. The circumference of the left leg was greater than that of the right by 5 cm 15 cm above the knee joint space and both legs had marked varicosities with congestive dermatitis | ||
| 520 | |a INVESTIGATIONS: The concentration of the thrombin-antithrombin complex was 13.4 micrograms/l, D-dimer 124 micrograms/l, prothrombin fragment F1+2 3,5 nmol/l and fibrin monomere 27.7 micrograms/ml, as expression of a manifest thrombosis. CT with contrast medium demonstrated the previously sonographically shown extent of the thrombosis. In addition the hepatic IVC segment was absent. The azygos vein was enlarged and there was an extensive collateral circulation | ||
| 520 | |a TREATMENT AND COURSE: Systemic thrombolysis (streptokinase for 3 days, then urokinase) for 11 days dissolved the thrombi and CT now demonstrated complete recanalization of the caudal deep vein system and the IVC abnormality (absence of hepatic segment). After intravenous thrombolysis oral anticoagulation with phenprocoumon was started and will be continued all the patient's life | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a English Abstract | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 7 | |a Fibrinolytic Agents |2 NLM | |
| 650 | 7 | |a Streptokinase |2 NLM | |
| 650 | 7 | |a EC 3.4.- |2 NLM | |
| 650 | 7 | |a Urokinase-Type Plasminogen Activator |2 NLM | |
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| 700 | 1 | |a Engelmann, L |e verfasserin |4 aut | |
| 700 | 1 | |a Scheel, H |e verfasserin |4 aut | |
| 700 | 1 | |a Siegemund, A |e verfasserin |4 aut | |
| 700 | 1 | |a Biesold, M |e verfasserin |4 aut | |
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