THROMBOSIS, DEEP-VEIN |
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DESCRIPTIONDeep-vein thrombosis is a blood clot that forms inside a vein. It may partially or completely block the blood flow, or break off and travel to the lung. This is different from clots in superficial veins, where clots rarely break off. Usually the lower legs (calves) or lower abdomen are involved, but occasionally this condition affects other veins in the body.
Appropriate health care includes:
Physician's monitoring of general condition and medications.
Hospitalization for anticoagulant injections (usually with heparin).
Self-care after hospitalization.
SIGNS & SYMPTOMS
Swelling and pain in the area drained by the vein, usually the ankle, calf, or thigh. Swelling in the leg includes everything below the clot, extending to the child's toes.
Tenderness and redness of the affected parts.
Soreness or pain when walking. The soreness does not disappear when your child rests.
Pain when raising the leg and flexing the foot (sometimes).
Fever (sometimes).
Increased heartbeat (sometimes).
CAUSES
Pooling of blood in the child's vein, which triggers blood-clotting mechanisms. The pooling may occur after prolonged bed rest following surgery, or from debilitating illness, such as a severe injury, or serious infections, stroke, or bone fractures.
RISK FACTORS
Obesity.
Smoking.
Use of estrogen in oral contraceptives. This is especially hazardous if estrogen use is combined with smoking.
PREVENTING COMPLICATIONS OR RECURRENCE
Your child should avoid prolonged bed rest during illnesses. The child should start moving the lower limbs as soon as possible after any surgical procedure or during any bed-confining illness.
On long auto or airplane trips, encourage the child to exercise the legs at least every 1 or 2 hours.
Urge the child to stop smoking, especially if taking estrogen for any purpose.
BASIC INFORMATION
MEDICAL TESTS
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory studies, such as ultrasound, radioactive fibrinogen, and prothrombin time (See Glossary for all).
X-rays of veins after dye is injected into a foot vein.
POSSIBLE COMPLICATIONSPulmonary embolism, in which the clot breaks away and travels to your child's lung. The lung's blood supply is blocked, causing affected lung tissue to die.
PROBABLE OUTCOME
Usually curable with anti-coagulant treatment, if pulmonary embolism can be avoided.
TREATMENT
HOME CAREThe following suggestions apply to your child after hospitalization or if the condition can be treated safely at home:
Wear fitted elastic stockings or wrapped elastic bandages, but don't wear garters or knee-high hosiery.
Don't cross your legs or ankles while sitting, lying in bed, or traveling.
Elevate the feet higher than the hips when sitting for long periods.
Elevate the foot of the bed.
MEDICATION
After your child's hospitalization, your doctor may prescribe oral anti-coagulant drugs, such as coumarin. To minimize the danger of pulmonary embolism, blood tests to monitor the anticoagulant levels are mandatory. Oral anticoagulants may be necessary up to 6 months.
ACTIVITY
Your child should rest in bed until all signs of inflammation have disappeared. While resting, the child should make it a habit to move the leg muscles, bend the ankles, and wiggle the toes.
DIET & FLUIDS
No special diet.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of deep-vein thrombosis.
The following occurs during treatment: unexpected bleeding anywhere; chest pain; coughing up blood; shortness of breath; continued or increased swelling and pain, despite treatment.
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