Combined radionuclide phlebography and lung scanning in patients operated on for scoliosis with the Harrington procedure.
Iliac vein thrombosis is an uncommon type of deep vein thrombosis (DVT) that occurs in young patients following surgical procedures for scoliosis. The symptomatology is diffuse and this type of DVT carries a risk for fatal pulmonary embolism as well as the development of a postphlebitic syndrome. Combined radionuclide phlebography and lung scanning were performed in 16 patients operated on for scoliosis with the Harrington procedure. In three patients with diffuse pain in the inguinal region, iliac vein thrombosis was easily visualized in the radionuclide phlebogram and confirmed by conventional phlebography in two cases. Six patients without lung symptoms had perfusion defects typical for pulmonary embolism. It is concluded that radionuclide phlebography can be recommended as a diagnostic procedure for iliac vein thrombosis in patients with diffuse symptoms in the inguinal region or the lower abdomen after scoliosis surgery. Advantages include the ease of performance, good patient acceptance and low radiation dose compared with conventional phlebography. Asymptomatic pulmonary embolism as diagnosed by the perfusion lung scan was an unexpected finding which raised clinical considerations that require further investigations.
D000293:Adolescent; D000328:Adult; D005268:Femoral Vein / Q000000981:diagnostic imaging*; D006801:Humans; D007084:Iliac Vein / Q000000981:diagnostic imaging*; D008168:Lung / Q000000981:diagnostic imaging*; D009983:Orthopedic Equipment; D010690:Phlebography; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging; D011877:Radionuclide Imaging; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013927:Thrombosis / Q000000981:diagnostic imaging