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中年男性深静脉血栓形成致足下垂的不常见表现:病例报告。

Foot Drop as an Unusual Presentation of Deep Vein Thrombosis In a Middle-Aged Man: A Case Report.

机构信息

Department of Emergency Medicine, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.

出版信息

Am J Case Rep. 2023 Mar 26;24:e938677. doi: 10.12659/AJCR.938677.

DOI:10.12659/AJCR.938677
PMID:36966353
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10061352/
Abstract

BACKGROUND Deep vein thrombosis (DVT) is a potentially fatal condition that occurs in 100 persons per 100 000 population, and accounts for 60 000 deaths per year in the United States, making its evaluation and diagnosis essential. Diagnosing DVT can be challenging due to symptom variations between patients. There are no previous reports of DVT patients presenting with foot drop in the literature. Therefore, the purpose of this case report is to present an unusual presentation of DVT in a middle-aged man with no clearly identifiable risk factors for DVT. CASE REPORT A 54-year-old otherwise symptom-free male smoker (for 30 years) presented to the Emergency Department complaining of pain in the left leg, which then escalated to weakness and decreased sensation in the left foot. However, he was able to walk with limping. Upon his presentation to the Emergency Department, he stated that his left leg felt quite weak. The neurological examination did not show any remarkable results, except for unilateral limb weakness. After that, a point-of-care ultrasound was carried out, which showed the possibility of non-compressible veins; then, a D-dimer test was conducted. When it tested positive, an official ultrasound was done, which showed thrombi in the left external iliac and common and superficial femoral veins. CONCLUSIONS This study reported a unique presentation of foot drop due to DVT in a middle-aged man, with the absence of known risk factors. Utilizing point-of-care ultrasound is a valuable tool in the evaluation of acute unilateral lower limb weakness.

摘要

背景

深静脉血栓形成(DVT)是一种潜在的致命疾病,在美国每 100000 人中就有 100 人患病,每年导致 60000 人死亡,因此评估和诊断至关重要。由于患者之间的症状差异,DVT 的诊断具有挑战性。文献中没有 DVT 患者出现足下垂的报道。因此,本病例报告的目的是报告一例中年男性不常见的 DVT 表现,该患者无明确的 DVT 危险因素。

病例报告

一名 54 岁、无其他症状的男性吸烟者(吸烟 30 年)因左腿疼痛就诊于急诊科,随后左腿疼痛加剧,并出现左足无力和感觉减退,但仍能跛行。就诊于急诊科时,他表示左腿非常无力。神经系统检查除单侧肢体无力外无明显异常。随后进行了床边超声检查,提示可能存在不可压缩的静脉;然后进行了 D-二聚体检测。当检测结果为阳性时,进行了正式的超声检查,显示左侧髂外、股总及股浅静脉有血栓。

结论

本研究报告了一例中年男性因 DVT 引起的独特足下垂表现,且无已知的危险因素。床边超声在急性单侧下肢无力的评估中是一种有价值的工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/e32da8b03c8e/amjcaserep-24-e938677-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/511703f859e3/amjcaserep-24-e938677-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/07683e376976/amjcaserep-24-e938677-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/e32da8b03c8e/amjcaserep-24-e938677-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/511703f859e3/amjcaserep-24-e938677-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/07683e376976/amjcaserep-24-e938677-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7405/10061352/e32da8b03c8e/amjcaserep-24-e938677-g003.jpg

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Ann Transl Med. 2021 Oct;9(20):1605. doi: 10.21037/atm-21-2772.
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Open Access Maced J Med Sci. 2019 Dec 20;7(24):4250-4254. doi: 10.3889/oamjms.2019.369. eCollection 2019 Dec 30.
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Management of Deep Vein Thrombosis in Emergency Departments;Time to Change the Viewpoint.
Emerg (Tehran). 2016 Winter;4(1):47.
4
Residents case report: deep vein thrombosis in a high school baseball pitcher following ulnar collateral ligament (ucl) reconstruction.住院医师病例报告:一名高中棒球投手在尺侧副韧带(UCL)重建后发生深静脉血栓形成。
Int J Sports Phys Ther. 2013 Aug;8(4):472-81.
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A young man with deep vein thrombosis, hyperhomocysteinemia and cobalamin deficiency.一名患有深静脉血栓形成、高同型半胱氨酸血症和钴胺素缺乏症的年轻男子。
CMAJ. 2008 Jan 29;178(3):279-81. doi: 10.1503/cmaj.071415.