Hu Janie, Cox MaKayla, Yang Alexander
St. George's University School of Medicine, True Blue, Grenada.
Chemistry Department, University of Illinois Springfield, Springfield, IL 62703, USA.
J Surg Case Rep. 2021 Apr 22;2021(4):rjab101. doi: 10.1093/jscr/rjab101. eCollection 2021 Apr.
Although there is consensus that thromboprophylaxis is necessary for major orthopedic surgeries such a joint replacement, there is no widespread consensus on the need for thromboprophylaxis for minor arthroscopic surgery. Here, we present a case of deep vein thrombosis (DVT) and pulmonary embolism (PE) after a common arthroscopic meniscectomy in a healthy 20-year-old female collegiate athlete. The patient had no risk factors except for prior use of combined oral contraceptive pills (COCPs). Twenty hours after an uncomplicated right knee meniscectomy, patient presented to ED with right calf pain and cramping, and DVT was confirmed using ultrasound. One week later, patient presented again to ED with dyspnea and chest pain. PE was diagnosed on CT angiography. Despite the rarity of thromboembolic complications in minor arthroscopy surgery, the broadened use of thromboprophylaxis in patients with even few risk factors could prevent thromboembolic complications from occurring.
虽然对于诸如关节置换等大型骨科手术而言，血栓预防是必要的这一点已达成共识，但对于小型关节镜手术是否需要进行血栓预防，尚未形成广泛共识。在此，我们报告一例健康的20岁女性大学运动员在进行常见的关节镜半月板切除术后发生深静脉血栓（DVT）和肺栓塞（PE）的病例。该患者除了之前使用复方口服避孕药（COCPs）外，没有其他危险因素。在一次无并发症的右膝半月板切除术后20小时，患者因右小腿疼痛和抽筋到急诊科就诊，超声检查确诊为DVT。一周后，患者再次因呼吸困难和胸痛到急诊科就诊。CT血管造影诊断为PE。尽管在小型关节镜手术中血栓栓塞并发症很少见，但即使是危险因素很少的患者，扩大血栓预防的应用也可以预防血栓栓塞并发症的发生。
