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.



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


Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to  evolve over the coming week so keep checking #TeamHaem on Twitter for more information.

Please note – all cases on TeamHaem are entirely fictional to protect patient confidentiality.

TeamHaem are not a position of authority.  It is an educational platform to allow discussion and learning.



About TeamHaem

Online education and discussion about all things haematological
This entry was posted in Anticoagulation, Thrombosis and tagged , , , , , , , . Bookmark the permalink.