Omar Mohamed Ozaal A M, Fernando Thanoj
The National Hospital of Sri Lanka, Colombo, Sri Lanka.
SAGE Open Med Case Rep. 2022 Apr 4;10:2050313X221089121. doi: 10.1177/2050313X221089121. eCollection 2022.
Leg and foot swelling is inherently found in 70% of patients with critical limb-threatening ischaemia due to ischaemia, which does not necessitate any specific intervention. Unilateral leg swelling is a vital sign for the clinical suspicion and diagnosis of deep vein thrombosis and phlegmasia. There is a significant surgical dilemma to delay the diagnosis of deep vein thrombosis or phlegmasia in patients with critical limb-threatening ischaemia when a methodical approach is not followed. We report a case of proximal deep vein thrombosis in an elderly patient with ipsilateral critical limb-threatening ischaemia and discuss the role of diagnostic tools. The role of antiplatelets along with vitamin K antagonists, duration of anticoagulation, iliocaval venous obstruction, compression therapy and inferior vena cava filter is discussed.
因缺血导致严重肢体缺血的患者中，70% 本质上存在腿部和足部肿胀，这无需任何特殊干预。单侧腿部肿胀是临床怀疑和诊断深静脉血栓形成及血栓性静脉炎的重要体征。在未采用系统方法时，对于严重肢体缺血患者，延迟诊断深静脉血栓形成或血栓性静脉炎会带来重大手术困境。我们报告一例老年患者，其患有同侧严重肢体缺血并伴有近端深静脉血栓形成，并讨论诊断工具的作用。还讨论了抗血小板药物与维生素 K 拮抗剂的联合使用、抗凝持续时间、髂股静脉阻塞、压迫治疗及下腔静脉滤器的作用。
