A 60 year old male has been operated for carcinoma of caecum and right hemicolectomy has been done. On the 4th post-operative day, the patient develops fever, swelling and pain in the legs. The most impoant clinical entity one should look for is: March 2011
Urinary tract infection
Intravenous line infection
Chest infection
Deep vein thrombosis
Ans. D: Deep vein thrombosis Stasis is a predisposing factor for DVT, especially in the post-operative period Increasing age and trauma/ surgery, especially of the pelvis, hip and lower limb is a risk factor for DVT The most common presentation of a DVT is pain and swelling, especially in the calf of one lower limb DVT: DVT of the iliac, femoral, popliteal veins is suggested by unilateral leg swelling, warmth, pain and erythema Homan's sign: Forced dorsiflexion of the ankle causes pain in the calf The non-invasive test used most often to diagnose DVT is duplex venous USG Heaprin is used for DVT prophylaxis Bandaging and thrombolytic therapy is effective