Browsing by Subject "deep venous thrombosis"

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    The Incidence of Venous Thromboembolism in Children Following Colorectal Resection for Inflammatory Bowel Disease: A Multi-Center Study
    (Elsevier, 2020) Bence, Christina M.; Traynor, Michael D., Jr.; Polites, Stephanie F.; Ha, Derrick; Muenks, Pete; St. Peter, Shawn D.; Landman, Matthew P.; Densmore, John C.; Potter, D. Dean, Jr.; Surgery, School of Medicine
    Background/Purpose Children with inflammatory bowel disease (IBD) have increased risk for venous thromboembolism (VTE). We sought to determine incidence and risk factors for postoperative VTE in a multicenter cohort of pediatric patients undergoing colorectal resection for IBD. Methods Retrospective review of children ≤18 years who underwent colorectal resection for IBD from 2010 to 2016 was performed at four children's hospitals. Primary outcome was VTE that occurred between surgery and last follow-up. Factors associated with VTE were determined using univariable and multivariable analyses. Results Two hundred seventy-six patients were included with median age 15 years [13,17]. Forty-two children (15%) received perioperative VTE chemoprophylaxis, and 88 (32%) received mechanical prophylaxis. DVT occurred in 12 patients (4.3%) at a median of 14 days postoperatively [8,147]. Most were portomesenteric (n = 9, 75%) with the remaining catheter-associated DVTs in extremities (n = 3, 25%). There was no association with chemoprophylaxis (p > 0.99). On Cox regression, emergent procedure [HR 18.8, 95%CI: 3.18–111], perioperative plasma transfusion [HR 25.1, 95%CI: 2.4–259], and postoperative infectious complication [HR 10.5, 95%CI: 2.63–41.8] remained predictive of DVT. Conclusion Less than 5% of pediatric IBD patients developed postoperative VTE. Chemoprophylaxis was not protective but rarely used. Patients with risk factors identified in this study should be monitored or given prophylaxis for VTE.
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    Spontaneous Iliac Vein Rupture Due to May-Thurner Syndrome and Its Staged Management
    (Sage, 2019) Ingram, Michael; Miladore, Julia; Gupta, Alok; Maijub, John; Wang, Keisin; Fajardo, Andres; Motaganahalli, Raghu; Surgery, School of Medicine
    We present a case of a 58-year-old otherwise healthy women who presented with left lower extremity deep venous thrombosis and was found to have pulmonary embolism along with a ruptured left internal iliac vein. Our patient was hemodynamically stable upon presentation; therefore, a staged approach was undertaken. Initially, an inferior vena cava filter was placed and the patient was slowly advanced to therapeutic anticoagulation and subsequently discharged. She then returned 2 weeks after discharge for venogram, mechanical thrombectomy, and stenting. At 1-year follow-up in clinic, she was found to have patent stents and resolution of symptoms.