Archive for the ‘Clots in unusual locations’ Category
Stephan Moll, MD writes… Patients with cancer may have catheters in veins in their upper chest, neck or arm (central venous catheter, port), to enable chemotherapy, fluids or blood products to be given. These catheters increase a patient’s risk for developing an arm or neck clot (DVT) leading to arm or neck swelling, pain, and may be warmth and reddish discoloration. Typically, blood thinners are used in this situation to prevent the clot from getting bigger or breaking off and traveling to the lung to cause a lung clot (pulmonary embolism; PE). Limited data exist how to best manage these catheter-associated DVTs.
This week (Feb 18th, 2014) a guidance document on the prevention and management of catheter-associated upper extremity and neck DVT was published by one of the respected medical societies (International Society for Thrombosis and Haemostasis; ISTH) [ref 1].
A summary of the conclusions and treatment recommendations for health care professionals has been published on Clot Connect here.
Zwicker JI et al. Catheter-associated deep vein thrombosis of the upper extremity in cancer patients: guidance from the SSC of the ISTH. Feb 18th, 2014 (pre-published on the web) – link to abstract here.
Disclosures: I have no relevant financial disclosures.
Last updated: Feb 20th, 2014
Stephan Moll, MD writes…
Ischemic colitis is an uncommon disorder. It is typically not dangerous and resolves without treatment. For mostly unclear reasons multiple small or tiny blood vessels in the wall of the intestine (the large intestine = colon) have decreased blood flow or become blocked by small blood clots. This results in a lack of blood flow and oxygen delivery (ischemia = Latin for impaired oxygen supply) to a number of small areas of the intestinal wall. This leads patchy, superficial damage of the colon wall results. The damage areas often heal by themselves and no surgery is needed. The patient recovers spontaneously within a week or two. Often people have only one episode. Few people have two or more bouts. Read the rest of this entry »
CT scans and MRI scans are often done in medicine, for a variety of reasons. Every so often such a scan will detect a blood clot in a patient who has no symptoms from the clot. This is referred to as an “incidental VTE” (VTE = venous thromboembolism, i.e. clot in a vein) or “asymptomatic VTE”. Such a clot may be a DVT in the pelvis or leg, in the major abdominal vein (vena cava), or in one of the intestinal veins (portal vein, splenic vein, mesenteric vein, or renal vein). When such an incidental, asymptomatic VTE is discovered, the question arises whether the patient should be treated with “blood thinners” or not. Read the rest of this entry »
Stephan Moll, MD writes…
Sinus and cerebral vein clots are uncommon. They can lead to severe headaches, confusion, and stroke-like symptoms. They may lead to bleeding into the surrounding brain tissues. The clot can be triggered by infections of the ear, face, or neck, by estrogen use and pregnancy, and can be caused by inherited and acquired clotting disorders. The diagnosis is, unfortunately, sometimes initially missed by health care professionals, as a plain CT or MRI of the head can be normal. Read the rest of this entry »