T. Bohmeke et al., CARDIOGENIC-SHOCK DURING EMBOLIZING SAPHE NOUS FEMORAL THROMBOSIS - SONOGRAPHIC EVIDENCE DESPITE INCONSPICUOUS PHLEBOGRAPHY, Herz, Kreislauf, 28(10), 1996, pp. 296-299
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.