Key result
A repeat lower extremity ultrasound identified an extensive deep venous thrombosis in a patient whose initial Doppler study 11 days prior was negative.
Why the study?
Venous thromboembolisms are a major cause of morbidity and mortality globally, are often underdiagnosed, and frequently require emergency department evaluation.
Case Report (n=1)
This case reinforces the clinical importance of performing serial venous ultrasounds in patients with persistent symptoms of deep venous thrombosis after an initial negative study.
Negative initial Doppler does not exclude extensive DVT; leaves open optimal repeat-imaging protocols in high-suspicion cases.
Venous thromboembolisms (VTE), which include deep venous thrombosis (DVT) and pulmonary embolism (PE), are a major cause of morbidity and mortality in the United States and globally. This often underdiagnosed medical condition has many known risk factors including pregnancy, malignancy, immobility, exogenous estrogen use, and hereditary factors. A significant portion of emergency department visits involves ruling out these diseases. This case presents a woman with unilateral leg pain and swelling who initially had a negative emergency room workup including a negative lower extremity Doppler study. Upon a repeat visit, she was found to have extensive deep venous thrombosis and was diagnosed with B-cell lymphoma. This case highlights the importance of having patients return for repeat imaging if Dopplers are negative in the initial encounter.
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Cabrera et al. (2019) conducted a case report in Deep Venous Thrombosis (n=1). Repeat lower extremity ultrasound vs. Initial lower extremity ultrasound was evaluated on Diagnosis of deep venous thrombosis. A repeat lower extremity ultrasound identified an extensive deep venous thrombosis in a patient whose initial Doppler study 11 days prior was negative.
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