Cm Chandrashekara, George Mulamoottil Abraham
Department of orthopedic surgery, Al-Buraimi Hospital, P.O.B 8, P.code 512. Al-Buraimi. Sultanate of Oman.
J Orthop Case Rep. 2016 Apr-Jun;6(2):72-74. doi: 10.13107/jocr.2250-0685.442.
The incidence of deep vein thrombosis (DVT) in pediatric patients is significantly much lower than adults. Most of the pediatric in-patients with major trauma, sepsis do not undergo routine screening for DVT.
We present a case of a 12-year-old boy presented to us with minor trauma to right ankle associated with swelling, pain and had associated cough, and fever. On investigation with plain X-ray of right ankle/chest, and blood parameters, patient was suspected of having cellulitis of right leg with chest infection. Patient was treated with IV Cloxacillin and ample of rest. During the course of treatment, patient's condition deteriorated with fever, tachycardia and a swollen leg without much pain. Duplex scan was performed where the right leg revealed thrombosis of popliteal vein, while CT scan of chest with angiogram ruled out possibility of pulmonary embolism. However, CT chest showed pneumonia with pulmonary effusion. Patient was treated with low molecular heparin and IV Cloxacillin for pneumonia. Patient recovered completely and there was no recurrence during follow up period of 6 months.
The possibility of DVT in pediatric should be kept in mind and when suspected, should be properly investigated and treated.
儿科患者深静脉血栓形成（DVT）的发生率明显低于成人。大多数患有严重创伤、脓毒症的儿科住院患者未接受DVT的常规筛查。
我们报告一例12岁男孩，因右踝轻度创伤就诊，伴有肿胀、疼痛，并有咳嗽和发热。经右踝/胸部X线平片及血液参数检查，患者被怀疑患有右小腿蜂窝织炎伴胸部感染。患者接受了静脉注射氯唑西林治疗并充分休息。在治疗过程中，患者病情恶化，出现发热、心动过速，腿部肿胀但疼痛不明显。进行了双功超声扫描，结果显示右腘静脉血栓形成，而胸部CT血管造影排除了肺栓塞的可能性。然而，胸部CT显示有肺炎伴胸腔积液。患者接受了低分子肝素治疗及针对肺炎的静脉注射氯唑西林治疗。患者完全康复，在6个月的随访期内未复发。
应牢记儿科患者发生DVT的可能性，一旦怀疑，应进行适当的检查和治疗。
