[Isolated thrombosis of the vena profunda femoris as the source of embolisms. A diagnosis easy to supply using duplex sonography].

HISTORY AND ADMISSION FINDINGS

A 79-year old man was admitted because of increasing dyspnoea. At physical examination he had dyspnoea at rest, auscultation of the lung was unremarkable and there was no peripheral oedema or unilateral swelling of a leg to suggest venous thrombosis.

INVESTIGATIONS AND DIAGNOSIS

Chest radiogram was unremarkable. Perfusion scintigraphy of the lung, performed to exclude pulmonary embolism, revealed several defects typical of emboli. Duplex sonography revealed an isolated thrombosis of the left profunda femoris vein, while the deep veins were patent.

TREATMENT AND COURSE

Anticoagulation with heparin followed by phenprocoumon rapidly improved the symptoms and the patient was discharged after 10 days.

CONCLUSION

Thrombosis of the profunda femoris vein can cause clinically relevant pulmonary embolism. While this vessel cannot be visualized by phlebography, duplex sonography easily establishes the diagnosis and should be used routinely in the investigation of suspected thrombosis of the leg veins.