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Pathology
Formation of a clot in a deep vein, usually of the lower extremities or pelvis
Aetiology
Virchow’s Triad:
- Venous stasis e.g. immobility, CCF, dehydration and venous obstruction
- Endothelial Injury e.g. trauma, inflammation and previous thrombosis
- Hypercoagulable state e.g. malignancy, oestrogen therapy, surgery and
abnormalities of the clotting cascade
Signs
Homan’s Sign: increased pain on dorsiflexion in calf DVT
Symptoms
Pain, swelling, erythema, warmth, pitting oedema
Investigations
Bloods: D-dimer
Imaging: Ultrasound Doppler studies, venogram.
Treatment
Medical: Low molecular weight heparin, oral anticoagulant Support stockings,
investigation of underlying cause, IVC filter
Prognosis
Good if promptly and adequately treated, risk of recurrence
Pulmonary embolism, extension of thrombus, post thrombotic syndrome, recurrence of DVT
Key Facts
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Key Images
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Key References
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