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Báo cáo khoa hoc:" Postoperative phlegmasia caerulea dolens: a case report and consideration of potential iatrogenic factors"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Postoperative phlegmasia caerulea dolens: a case report and consideration of potential iatrogenic factors | Journal of Medical Case Reports BioMed Central Case report Open Access Postoperative phlegmasia caerulea dolens a case report and consideration of potential iatrogenic factors Ronan A Cahill and HP Redmond Address Department of Academic Surgery NUI Cork Cork University Hospital Wilton Cork Ireland Email Ronan A Cahill - rcahill@rcsi.ie HP Redmond - Henry.Redmond@mailp.hse.ie Corresponding author Published I December 2007 Received 14 August 2007 t__AAA-7 I.IZA J.i.m I loz nr i IOJ7 I IZA Accepted 1 December 2007 Journal of Medical Case Reports 2007 1 163 doi 10.1186 1752-1 947-1-163 r This article is available from http www.jmedicalcasereports.com content 1 1 163 2007 Cahill and Redmond licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http creativecommons.org licenses by 2.0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract While the haemorrhagic consequences of anti-coagulants are well and frequently described in the surgical literature the paradoxical prothrombotic tendencies of these drugs tend to be underrecognised due perhaps to their clinical infrequency. However when these effects pertain their consequences can be devastating. Here we present a postoperative oncology patient who suffered a massive recrudescence of his lower limb venous thrombosis immediately after discontinuation of his heparin infusion despite seemingly being adequately anticoagulated by warfarin therapy INR 2.0 . We intend this case to graphically illustrate the theoretical considerations that must govern the perioperative use of these drugs in high-risk patients. Introduction Despite increasingly effective regimens for its prophylaxis and prevention venous thrombo-embolic disease remains a common and serious cause of both morbidity and mortality in surgical patients. 1 As predisposing and precipitating factors .