[Diagnosis of postoperative venous thromboembolism]

AN IMPORTANT SUBJECT: The thromboembolic disease still prevails in the context of surgery, despite the progression in prophylaxis. Particular attention must be paid to the possibility of delayed events, often occurring within the three months following a surgical procedure. Although many general studies, assessing supplementary examination or diagnostic strategies are available, the proportion of patients concerned by a post-operative context varies.

The Doppler is the diagnostic examination of choice in the case of suspected deep vein thrombosis, but it is not recommended in a strategy of screening for asymptomatic thrombosis in surgery. A suspected embolism can be confirmed or eliminated using noninvasive examinations, but it requires that invasive tests be performed more often than in a medical context. The indication for a helical computed tomography, presently more readily available than a pulmonary angiography, would appear legitimate, so long as a Doppler of the lower limbs is systematically associated. RESERVATIONS IN THE POST-OPERATIVE PERIOD: The results of this strategy, most satisfactory in the majority of patients, do not appear as interesting post-operatively. The studies targeting the management of suspected post-operative pulmonary embolism are rare and warrant further encouragement.