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Sıradışı Bir Olgu Sunumu: Sağ İliak Ve Femoral Ven Trombüsü

Year 2022, Volume: 5 Issue: 2, 86 - 88, 30.06.2022
https://doi.org/10.54996/anatolianjem.1077385

Abstract

Amaç: Karın ağrısı, acil servise en sık başvuru nedenleri arasındadır. Karın ağrısı spesifik olmayabilir ve altta yatan nedeni doğru bir şekilde belirleme zorluğunu artırır. Derin ven trombozunun klasik semptomları ödem, kızarıklık, etkilenen bölgede ağrı ve palpasyonda hassasiyettir. Bu olgu sunumunda karın ağrısı şikayeti ile acil servise başvuran genç bir hastada sağ iliak ve femoral vende saptanan trombüsü göstermeyi amaçladık.


Olgu: 18 yaşında kadın hasta son üç gündür şiddetlenen karın ağrısı şikayeti ile acil servise başvurdu. Akut apandisit ve adneksiyal patolojileri dışlamak için abdominal ultrason istendi. Abdominal ultrasonda herhangi bir patoloji saptanmadı. Hastanın obstetrik ve jinekolojik muayenesi sırasında yapılan Doppler ultrasonda sağ femoral vende şüpheli trombüs görüntüsü saptandı ve kontrastlı karın bilgisayarlı tomografisi istendi. Sağ iliak ve femoral venlerde trombüs tespit edilen hasta venöz tromboemboli nedeniyle hastaneye yatırıldı.


Sonuç: Karın ağrısı ile acil servise başvuran tüm hastalarda (genç hastalar dahil) venöz tromboemboli tanısının acil hekimleri için akılda tutulması önemlidir.

References

  • Kamin RA, Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am. 2003;21(1):61-72. doi:10.1016/S0733-8627(02)00080-9.
  • Laméris W, van Randen A, van Es HW, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. The BMJ. 2009;338:b2431. doi:10.1136/bmj.b2431.
  • Guneysu F, Durmus E. Predictive role of serum markers in the evaluation of acute abdomen. Journal of Contemporary Clinical Practice. 2021;7(2):48-55. doi:10.18683/jccp.2021.1071.
  • Gans SL, Pols MA, Stoker J, Boermeester MA, Group OB of the ES. Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain. Dig Surg. 2015;32(1):23-31. doi:10.1159/000371583.
  • Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous Thromboembolism: A Public Health Concern. Am J Prev Med. 2010;38(4):S495-S501. doi:10.1016/j.amepre.2009.12.017.
  • Kahn SR. The post-thrombotic syndrome: progress and pitfalls. Br J Haematol. 2006;134(4):357-365. doi:10.1111/j.1365-2141.2006.06200.x.
  • Schulman S, Lindmarker P, Holmström M, et al. Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost. 2006;4(4):734-742. doi:10.1111/j.1538-7836.2006.01795.x.
  • Enden T, Haig Y, Kløw NE, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. The Lancet. 2012;379(9810):31-38. doi:10.1016/S0140-6736(11)61753-4.
  • Govender I, Rangiah S, Bongongo T, Mahuma P. A primary care approach to abdominal pain in adults. South Afr Fam Pract. 2021;63(1):5280. doi:10.4102/safp.v63i1.5280.
  • Cartwright SL, Knudson MP. Diagnostic Imaging of Acute Abdominal Pain in Adults. Am Fam Physician. 2015;91(7):452-459.
  • Crous-Bou M, Harrington LB, Kabrhel C. Environmental and Genetic Risk Factors Associated with Venous Thromboembolism. Semin Thromb Hemost. 2016;42(8):808-820. doi:10.1055/s-0036-1592333.
  • Mangla A, Hamad H. May-Thurner Syndrome. In: StatPearls. StatPearls Publishing; 2022. Accessed February 11, 2022. http://www.ncbi.nlm.nih.gov/books/NBK554377/.

An Extraordinary Case Presentation: Right Iliac and Femoral Vein Thrombus

Year 2022, Volume: 5 Issue: 2, 86 - 88, 30.06.2022
https://doi.org/10.54996/anatolianjem.1077385

Abstract

Aim: Abdominal pain is among the most common reasons for admission to the emergency department. Abdominal pain may be nonspecific, increasing the difficulty of accurately identifying the underlying cause. The classic symptoms of deep vein thrombosis are edema, redness, pain in the affected area, and tenderness on palpation. This case report aimed to demonstrate the thrombus observed in the right iliac and femoral vein in a young patient who applied to the ED with abdominal pain.


Case: An 18-year-old female patient applied to the emergency department with the complaint of abdominal pain that had worsened for the last three days. Abdominal ultrasound was requested to exclude acute appendicitis and adnexal pathologies. Abdominal ultrasound did not detect any pathology. Doppler ultrasound performed during obstetric and gynecological examination of the patient showed a suspicious thrombus image in the right femoral vein and contrast-enhanced abdominal computed tomography was requested. The patient, who was found to have thrombus in the right iliac and femoral veins, was hospitalized due to venous thromboembolism.


Conclusion: It is important for emergency physicians to keep venous thromboembolism in mind as a diagnosis in all patients (including young patients) presenting with abdominal pain.

References

  • Kamin RA, Nowicki TA, Courtney DS, Powers RD. Pearls and pitfalls in the emergency department evaluation of abdominal pain. Emerg Med Clin North Am. 2003;21(1):61-72. doi:10.1016/S0733-8627(02)00080-9.
  • Laméris W, van Randen A, van Es HW, et al. Imaging strategies for detection of urgent conditions in patients with acute abdominal pain: diagnostic accuracy study. The BMJ. 2009;338:b2431. doi:10.1136/bmj.b2431.
  • Guneysu F, Durmus E. Predictive role of serum markers in the evaluation of acute abdomen. Journal of Contemporary Clinical Practice. 2021;7(2):48-55. doi:10.18683/jccp.2021.1071.
  • Gans SL, Pols MA, Stoker J, Boermeester MA, Group OB of the ES. Guideline for the Diagnostic Pathway in Patients with Acute Abdominal Pain. Dig Surg. 2015;32(1):23-31. doi:10.1159/000371583.
  • Beckman MG, Hooper WC, Critchley SE, Ortel TL. Venous Thromboembolism: A Public Health Concern. Am J Prev Med. 2010;38(4):S495-S501. doi:10.1016/j.amepre.2009.12.017.
  • Kahn SR. The post-thrombotic syndrome: progress and pitfalls. Br J Haematol. 2006;134(4):357-365. doi:10.1111/j.1365-2141.2006.06200.x.
  • Schulman S, Lindmarker P, Holmström M, et al. Post-thrombotic syndrome, recurrence, and death 10 years after the first episode of venous thromboembolism treated with warfarin for 6 weeks or 6 months. J Thromb Haemost. 2006;4(4):734-742. doi:10.1111/j.1538-7836.2006.01795.x.
  • Enden T, Haig Y, Kløw NE, et al. Long-term outcome after additional catheter-directed thrombolysis versus standard treatment for acute iliofemoral deep vein thrombosis (the CaVenT study): a randomised controlled trial. The Lancet. 2012;379(9810):31-38. doi:10.1016/S0140-6736(11)61753-4.
  • Govender I, Rangiah S, Bongongo T, Mahuma P. A primary care approach to abdominal pain in adults. South Afr Fam Pract. 2021;63(1):5280. doi:10.4102/safp.v63i1.5280.
  • Cartwright SL, Knudson MP. Diagnostic Imaging of Acute Abdominal Pain in Adults. Am Fam Physician. 2015;91(7):452-459.
  • Crous-Bou M, Harrington LB, Kabrhel C. Environmental and Genetic Risk Factors Associated with Venous Thromboembolism. Semin Thromb Hemost. 2016;42(8):808-820. doi:10.1055/s-0036-1592333.
  • Mangla A, Hamad H. May-Thurner Syndrome. In: StatPearls. StatPearls Publishing; 2022. Accessed February 11, 2022. http://www.ncbi.nlm.nih.gov/books/NBK554377/.
There are 12 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Case Report
Authors

Sacit Akdeniz 0000-0002-4573-4433

Bilge Ercan 0000-0003-1953-9025

Yusuf Yurumez 0000-0003-3917-9434

Ensar Durmuş 0000-0001-7722-6639

Necip Gökhan Guner 0000-0001-5052-9242

Veysel Yılmaz This is me 0000-0002-6141-5061

Publication Date June 30, 2022
Published in Issue Year 2022 Volume: 5 Issue: 2

Cite

AMA Akdeniz S, Ercan B, Yurumez Y, Durmuş E, Guner NG, Yılmaz V. An Extraordinary Case Presentation: Right Iliac and Femoral Vein Thrombus. Anatolian J Emerg Med. June 2022;5(2):86-88. doi:10.54996/anatolianjem.1077385