Keeling S L, Numa A, Wilde P, Davis J, McLellan J
Royal Children's Hospital, Parkville, VIC.
Med J Aust. 1993 Jan 4;158(1):50-1. doi: 10.5694/j.1326-5377.1993.tb121654.x.
To present the first case of deep venous thrombosis caused by femoral exostosis reported in Australia.
An 11-year-old prepubertal Caucasian girl had a two-year history of a posterior femoral exostosis. She then presented with a deep venous thrombosis 24 hours after riding a horse for the first time. The deep venous thrombosis was diagnosed by Doppler ultrasound, which showed an intimate relationship between the femoral exostosis and the femoral vein. Coagulation abnormalities were excluded.
The patient was given anticoagulation therapy with heparin intravenously and warfarin orally. The popliteal vein recanalised within two days. The exostosis was excised 10 weeks after initial presentation, with warfarin being continued for four weeks postoperatively. Two months after excision the patient was symptom free.
It is possible for venous compression by an exostosis to result in thrombosis in a patient with no underlying coagulation abnormality. Palpation and plain radiography of the region will demonstrate the exostosis; ultrasound is the next investigation of choice.
报告澳大利亚首例因股骨外生骨疣导致的深静脉血栓形成病例。
一名11岁青春期前的白种女孩有股骨后外侧外生骨疣病史两年。她在首次骑马24小时后出现深静脉血栓形成。通过多普勒超声诊断为深静脉血栓形成，显示股骨外生骨疣与股静脉关系密切。排除了凝血异常。
患者接受了静脉注射肝素和口服华法林的抗凝治疗。腘静脉在两天内再通。初次就诊10周后切除外生骨疣，术后继续服用华法林四周。切除术后两个月患者无症状。
在无潜在凝血异常的患者中，外生骨疣压迫静脉有可能导致血栓形成。该区域的触诊和平片将显示外生骨疣；超声是下一步的首选检查。
