[Deep venous thrombosis in an amputation stump].
A 34-year-old patient underwent a knee exarticulation amputation and developed symptoms of pain, redness and swelling of the stump in combination with a feeling of tightness in the chest. These symptoms were first attributed to muscle pain and exertion but further examination revealed deep venous thrombosis (DVT) of the stump and a pulmonary embolism for which he was treated with nadroparine and acenocoumarol. Shortly after treatment he could resume the use of the prosthesis. A DVT in the amputation stump is not frequently encountered, but is a serious complication that can, together with a pulmonary embolism, be life threatening. The literature mentions an incidence ranging from 0-12%. Physical examination is often not conclusive and further examination of the patient with duplex scanning is necessary, with a ventilation-perfusion scan if a pulmonary embolism is suspected. Patients with a lower extremity amputation have a higher risk of developing a DVT because of immobility and increased venous pooling in the residual limb. Symptoms of a red, swollen, warm and painful stump should trigger the physician to suspect a DVT.
Baars
E C T
EC
Centrum voor Revalidatie, Postbus 1057, 8001 BB Zwolle. e.c.t.baars@vogellanden.nl
Ettema
H B
HB
Fritschy
W M
WM
D000074:Acenocoumarol / Q000627:therapeutic use; D000328:Adult; D000671:Amputation, Surgical / Q000009:adverse effects*; D000672:Amputation Stumps / Q000098:blood supply*; D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D017762:Nadroparin / Q000627:therapeutic use; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000188:drug therapy
D000925:Anticoagulants; D017762:Nadroparin; D000074:Acenocoumarol