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Surgery 2 - Third Year BHMS

Contents

Surgery 2 - Third Year BHMS

Contents

CoursesBHMSSurgery 2 - Third Year BHMSVENOUS THROMBOSIS AND DEEP VEIN THROMBOSIS (DVT)

VENOUS THROMBOSIS AND DEEP VEIN THROMBOSIS (DVT)

Content

Venous Thrombosis and Deep Vein Thrombosis (DVT)

Definition and Types

  • Venous thrombosis is the formation of a blood clot in a vein.
  • Deep Vein Thrombosis (DVT) is a blood clot that forms in the deep veins of the body, typically in the legs.

Aetiology

  • Age: Older adults are more prone to DVT.
  • Family history: Individuals with a family history of DVT or blood clots are more likely to develop DVT.
  • Surgery: Patients undergoing surgery, especially hip or knee replacement, are at higher risk for DVT.
  • Cancer: People with cancer, particularly pancreatic, lung, and stomach cancer, are at increased risk of DVT.
  • Pregnancy: Pregnant women are at higher risk for DVT due to increased blood clotting.
  • Immobility: People who are immobile for extended periods, such as those confined to bed or wheelchair, are at higher risk for DVT.
  • Trauma: Severe trauma, such as a car accident or fall, can increase the risk of DVT.
  • Inherited blood clotting disorders: Individuals with inherited blood clotting disorders, such as Factor V Leiden, are at higher risk for DVT.

Pathology

  • A blood clot forms in a vein due to a combination of factors, including:
    • Damage to the vein wall
    • Stasis of blood flow
    • Hypercoagulability of blood
    • Activation of the coagulation cascade
  • The clot can break loose and travel to the lungs, causing a pulmonary embolism.

Clinical Features

  • Sudden onset of pain in the affected leg
  • Swelling and redness in the affected leg
  • Warmth and tenderness to the touch in the affected leg
  • Shortness of breath or chest pain (if the clot has broken loose and traveled to the lungs)

Diagnosis

  • Physical examination
  • Doppler ultrasound
  • Computed Tomography (CT) scan
  • Magnetic Resonance Imaging (MRI)

Investigations

  • Complete Blood Count (CBC) to check for signs of infection or inflammation
  • Prothrombin Time (PT) and Partial Thromboplastin Time (PTT) to assess blood clotting
  • D-dimer test to check for the presence of blood clots
  • Imaging studies to confirm the presence and location of the blood clot

Complications

  • Pulmonary embolism
  • Post-thrombotic syndrome (PTS)
  • Recurrent DVT

Management

  • Anticoagulation therapy to prevent further clotting
  • Thrombolysis to dissolve the existing clot
  • Mechanical methods to remove the clot
  • Immobilization and compression stockings to promote blood flow

Homeopathic Treatment

  • Arnica Montana for pain and inflammation
  • Hamamelis Virginiana for varicose veins and hemorrhoids
  • Pulsatilla for pain and inflammation
  • Bryonia for pain and inflammation
  • Nux Vomica for pain and inflammation
  • Rhus Tox for pain and inflammation

Operative Management

  • In severe cases, surgery may be necessary to: โ†’ Remove the clot โ†’ Repair or replace the damaged vein โ†’ Perform a vascular procedure to improve blood flow

Post-operative Care

  • Immobilization and compression stockings to promote blood flow
  • Anticoagulation therapy to prevent further clotting
  • Regular follow-up appointments to monitor for complications