Case 58 – update 3

Our patient has a swollen left leg and an intermediate Wells’ score but a positive d-dimer result. She goes on to have an ultrasound of her lower limb. There is debate on whether to do a full leg ultrasound scan or just proximal (i.e. not image the calf veins). More of that in the summary. If the ultrasound cannot be completed within four hours a dose of anticoagulation should be given.

 

In our patient an ultrasound of the proximal veins revealed a DVT in the femoral vein (beware – sometimes called the superficial femoral vein!).

 

She has a full blood count, coagulation screen, U&E, LFT and bone profile performed.

 

Questions

  • What will you use to treat the patient’s DVT?
  • How would you investigate a potential cause?

 

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