CARDIOGENIC-SHOCK DURING EMBOLIZING SAPHE NOUS FEMORAL THROMBOSIS - SONOGRAPHIC EVIDENCE DESPITE INCONSPICUOUS PHLEBOGRAPHY

A 73 year old female patient suffered marked breathlessness after a he mmorrhoid operation, multiple pulmonary embolisms were detected scinti graphically. An inconspicuous pelvic and upper thigh were detected phl ebographically. Thrombosis of the large saphenous vein of the right si de reaching into the main femoral vein was detected by colour coded so nography. The findings were confirmed intra operatively and initially a thrombectomy and a crossectomy were carried out. The intra- and post -operative progress was complicated by circulatory instability and per sistent hypoxia, after 4 days of controlled ventilation and catecholam ine therapy the patient recovered. The following colour coded sonograp hy controls showed an appositional thrombosis of the large saphenous v ein on the contralateral side, so that a crossectomy was carried out o n the left side. Colour coded sonography can supplement phlebography b y discovering decisive therapy findings and ought to be carried out in addition to phlebography in cases of proven pulmonary embolisms.