Department of Cardiology and Intensive Care Medicine, Bogenhausen Hospital, Munich, Germany.
Clin Appl Thromb Hemost. 2011 Apr;17(2):232-4. doi: 10.1177/1076029609351878. Epub 2009 Dec 2.
A 32-year-old woman with severe foot pain came to our emergency department after a busy night duty in hospital followed by an extended sleep period. Physical examination revealed a discrete swelling of the medial aspect of the right foot and a painful plantar arch during digital examination. Magnetic resonance imaging (MRI) with intravenous gadolinium showed filling defects in the lateral plantar vein. Doppler sonography displayed noncompressible structures in the plantar veins without flow signals, suggesting a plantar vein thrombosis. Therapy was initiated with low-molecular-weight heparin in combination with customized elastic bandages for the lower leg. Follow-up sonography 6 weeks later showed complete patency of the plantar veins. To our knowledge, we present the first case of isolated plantar vein thrombosis independent of trauma, surgery, or malignant disease, most probably caused by a busy night duty on the intensive care unit (ICU) followed by a prolonged sleeping period.
一位 32 岁女性，在医院繁忙的夜班后长时间睡眠，随后出现严重足部疼痛，来到我们的急诊部。体格检查显示右足内侧有局限性肿胀，数字检查时足底弓有压痛。静脉内钆造影磁共振成像（MRI）显示外侧足底静脉有充盈缺损。多普勒超声显示足底静脉无血流信号的不可压缩结构，提示足底静脉血栓形成。治疗采用低分子肝素联合小腿定制弹性绷带。6 周后的随访超声显示足底静脉完全通畅。据我们所知，我们报告了首例无创伤、手术或恶性疾病的孤立性足底静脉血栓形成病例，很可能是由重症监护病房（ICU）繁忙的夜班后长时间睡眠引起的。
