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An Evaluation of Clinical Signs in the Diagnosis of Venous Thrombosis

An Evaluation of Clinical Signs in the Diagnosis of Venous Thrombosis Abstract The winds of change continue to blow through the problem of thromboembolic disease. This is not surprising when the etiology still remains obscure. Venous thrombosis not infrequently complicates a variety of medical, surgical, and obstetrical conditions. Pulmonary embolism may cause death when the outcome of surgery might otherwise have been successful. Statistically, pulmonary embolism is the greatest single cause of postoperative deaths as well as the commonest postoperative chest complication. In spite of the growing awareness of thromboembolism this disease remains a constant source of unpleasant surprises. The clinical diagnosis of incipient or even advanced venous thrombosis in the lower extremities is often impossible. Welch and Faxon1 found that in 128 cases of fatal embolism only 5% had clinical evidence of peripheral vein involvement. Coon and Coller2 reviewed a series of 595 cases of pulmonary embolism proved at autopsy. They found that only 7.1% had a clinical diagnosis References 1. Welch, C. E., and Faxon, H. H.: Thrombophlebitis and Pulmonary Embolism , J.A.M.A. 117: 1502, 1941.Crossref 2. Coon, W. W., and Coller, F. A.: Clinicopathologic Correlation in Thromboembolism , Surg. Gynec. Obstet. 109:259, 1959. 3. Schauble, J. F.; Stickel, D. L., and Anlyan, W. G.: Vena Caval Ligation for Thromboembolic Disease , Arch. Surg. 84:17, 1962.Crossref 4. Gibbs, N. M.: Venous Thrombosis of the Lower Limbs with Particular Reference to Bed-Rest , Brit. J. Surg. 45:209, 1957.Crossref 5. Paterson, J. C., and McLachlin, J.: Precipitating Factors in Venous Thrombosis , Surg. Gynec. Obstet. 98:96, 1954. 6. Rössle, R.: Über die Bedeutung und die Entstehung der Wadenvenenthrombosen , Virchow. Arch. Path. Anat. 300:180, 1937.Crossref 7. Neumann, R.: Ursprungszentren und Entwicklungsformen der Bein-Thrombose , Virchow. Arch. Path. Anat. 301:708, 1938.Crossref 8. Hunter, W. C.; Sneeden, V. D.; Robertson, T. D., and Snyder, G. A.: Thrombosis of Deep Veins of the Leg , Arch. Intern. Med. 68:1, 1941.Crossref 9. Allen, A. W.; Linton, R. R., and Donaldson, G. A.: Thrombosis and Embolism , Ann. Surg. 118: 728, 1943.Crossref 10. Homans, J.: Diseases of the Veins , N. Engl. J. Med. 231:51, 1944.Crossref 11. Homans, J.: Thrombophlebitis in the Legs , New Engl. J. Med. 218:594, 1938.Crossref 12. Milch, E.; Berman, L., and Egan, R. W.: Bishydroxycoumarin (Dicumarol) Prophylaxis: Use in Prevention of Postoperative Thromboembolic Complications in Surgical Patients , Arch. Surg. 83:444, 1961.Crossref 13. Sevitt, S., and Gallagher, N. G.: Prevention of Venous Thrombosis and Pulmonary Embolism in Injured Patients , Lancet 2:981, 1959.Crossref 14. McLachlin, A.; McLachlin, J.; Jory, T., and Rawling, E.: Venous Stasis in the Lower Extremities , Ann. Surg. 152:678, 1960.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

An Evaluation of Clinical Signs in the Diagnosis of Venous Thrombosis

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Publisher
American Medical Association
Copyright
Copyright © 1962 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1962.01310050040008
Publisher site
See Article on Publisher Site

Abstract

Abstract The winds of change continue to blow through the problem of thromboembolic disease. This is not surprising when the etiology still remains obscure. Venous thrombosis not infrequently complicates a variety of medical, surgical, and obstetrical conditions. Pulmonary embolism may cause death when the outcome of surgery might otherwise have been successful. Statistically, pulmonary embolism is the greatest single cause of postoperative deaths as well as the commonest postoperative chest complication. In spite of the growing awareness of thromboembolism this disease remains a constant source of unpleasant surprises. The clinical diagnosis of incipient or even advanced venous thrombosis in the lower extremities is often impossible. Welch and Faxon1 found that in 128 cases of fatal embolism only 5% had clinical evidence of peripheral vein involvement. Coon and Coller2 reviewed a series of 595 cases of pulmonary embolism proved at autopsy. They found that only 7.1% had a clinical diagnosis References 1. Welch, C. E., and Faxon, H. H.: Thrombophlebitis and Pulmonary Embolism , J.A.M.A. 117: 1502, 1941.Crossref 2. Coon, W. W., and Coller, F. A.: Clinicopathologic Correlation in Thromboembolism , Surg. Gynec. Obstet. 109:259, 1959. 3. Schauble, J. F.; Stickel, D. L., and Anlyan, W. G.: Vena Caval Ligation for Thromboembolic Disease , Arch. Surg. 84:17, 1962.Crossref 4. Gibbs, N. M.: Venous Thrombosis of the Lower Limbs with Particular Reference to Bed-Rest , Brit. J. Surg. 45:209, 1957.Crossref 5. Paterson, J. C., and McLachlin, J.: Precipitating Factors in Venous Thrombosis , Surg. Gynec. Obstet. 98:96, 1954. 6. Rössle, R.: Über die Bedeutung und die Entstehung der Wadenvenenthrombosen , Virchow. Arch. Path. Anat. 300:180, 1937.Crossref 7. Neumann, R.: Ursprungszentren und Entwicklungsformen der Bein-Thrombose , Virchow. Arch. Path. Anat. 301:708, 1938.Crossref 8. Hunter, W. C.; Sneeden, V. D.; Robertson, T. D., and Snyder, G. A.: Thrombosis of Deep Veins of the Leg , Arch. Intern. Med. 68:1, 1941.Crossref 9. Allen, A. W.; Linton, R. R., and Donaldson, G. A.: Thrombosis and Embolism , Ann. Surg. 118: 728, 1943.Crossref 10. Homans, J.: Diseases of the Veins , N. Engl. J. Med. 231:51, 1944.Crossref 11. Homans, J.: Thrombophlebitis in the Legs , New Engl. J. Med. 218:594, 1938.Crossref 12. Milch, E.; Berman, L., and Egan, R. W.: Bishydroxycoumarin (Dicumarol) Prophylaxis: Use in Prevention of Postoperative Thromboembolic Complications in Surgical Patients , Arch. Surg. 83:444, 1961.Crossref 13. Sevitt, S., and Gallagher, N. G.: Prevention of Venous Thrombosis and Pulmonary Embolism in Injured Patients , Lancet 2:981, 1959.Crossref 14. McLachlin, A.; McLachlin, J.; Jory, T., and Rawling, E.: Venous Stasis in the Lower Extremities , Ann. Surg. 152:678, 1960.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Nov 1, 1962

References