Munch Tina Nørgaard, Jespersen Christian
H:S Bispebjerg Hospital, Kardiologisk Klinik Y, Medicinsk Center.
Ugeskr Laeger. 2005 Aug 22;167(34):3193.
An otherwise healthy 48-year-old Caucasian male was admitted to hospital due to suspicion of right calf thrombosis. The symptoms were intermittent thickening and tension of the right calf for four days. There was no history of trauma. Clinical signs and symptoms and a d-dimer of 1.4 (< 0.5 mg/l) indicated deep venous thrombosis, and anticoagulation treatment was started with confirmatory ultrasound planned for the following morning. Overnight, the pains and swelling increased significantly and decreased sensitivity on the medial side of the foot was found, suggesting compartment syndrome. Ultrasound showed no sign of DVT, but a large haematoma was seen in the deep posterior compartment of the calf, and an acute fasciotomy was done. This case report emphasizes the importance of utilising ultrasound before starting anticoagulation therapy in patients suspected of having DVT.
一名48岁的健康白种男性因疑似右小腿血栓形成入院。症状为右小腿间歇性增厚和紧张感,持续四天。无外伤史。临床症状体征及D - 二聚体为1.4(<0.5mg/l)提示深静脉血栓形成,遂开始抗凝治疗,并计划次日上午进行超声检查以确诊。当晚,疼痛和肿胀显著加重,且发现足部内侧感觉减退,提示骨筋膜室综合征。超声检查未显示深静脉血栓形成迹象,但在小腿后深室发现一个大血肿,遂进行了急性筋膜切开术。本病例报告强调了在怀疑患有深静脉血栓形成的患者开始抗凝治疗前使用超声检查的重要性。