RT Journal Article
SR Electronic
T1 When Deep Venous Thrombosis Fails to Respond to Therapy
JF The Journal of the American Board of Family Practice
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 246
OP 250
DO 10.3122/jabfm.16.3.246
VO 16
IS 3
A1 LaPorte, Dawn
A1 Farber, Sharon
A1 Sorin, Sergei
A1 Wahba, Sara
A1 Daneels, Elizabeth
A1 Korzenko, Adam
A1 Kopes-Kerr, Colin P.
YR 2003
UL http://www.jabfm.org/content/16/3/246.abstract
AB Background: Deep venous thrombosis in primary care is usually treated with rest, analgesics, intravenous or low-molecular-weight heparin, and coumadin. In some cases, however, a less familiar course of diagnosis and management is required.Methods: We describe the case of a 53-year-old truck driver who had an acute deep venous thrombosis of his right lower extremity, which failed to respond to routine therapy with heparin and warfarin. A literature search was undertaken to research the differential diagnosis and management of deep venous thrombosis and to review specifically the role of venal caval filters and inherited thrombotic disorders and occult cancer in this context.Results and Conclusion: The ultimate diagnosis in our patient appeared to be signet ring cell cancer of the colon that had metastasized to the right thigh. This case is an example of the inherent limitations of even an aggressive diagnostic and therapeutic approach to the entity of refractory deep venous thrombosis.