Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Jan 2008
Managing suspected venous thromboembolism in a mixed primary and secondary care setting using standard clinical assessment and D-dimer in a noninvasive diagnostic strategy.
Venous thromboembolism is a potentially lethal disease if not properly treated. Noninvasive strategies have become an attractive clinical option for effective diagnosis. There has been controversy, however, regarding the use of standard clinical rules in a primary care setting. ⋯ Proportions of patients with venous thromboembolic events observed were 7.2% in patients with an unlikely diagnosis of deep venous thrombosis and 3.0% in those with low probability for pulmonary embolism. The percentage of patients with a thrombotic event excluded using this strategy was 37% (positive predictive value 13%, negative predictive value 100%). In conclusion, this noninvasive clinical strategy is safe for ruling out venous thromboembolism, and excludes the need for imaging tests in about one-third of the patients in the population studied.
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Blood Coagul. Fibrinolysis · Jan 2008
Case ReportsPhlegmasia cerulea dolens as a complication of a severe form of acute hemorrhagic-necrotizing pancreatitis.
Phlegmasia cerulea dolens is an extreme form of deep venous thrombosis with a proximal localization of the blockage, most frequently in the ileofemoral area. Symptoms are graded as follows: swelling of the entire extremity, pain, and cyanosis. ⋯ Diagnosis of phlegmasia usually causes no problems because the proper diagnosis is usually revealed during clinical examination and confirmed by imaging techniques. The authors present a case report of phlegmasia cerulean dolens and discuss the options for treatment.