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Related Concept Videos

Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

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Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies01:20

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

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The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
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Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Venous Thrombosis IV: Nursing Management01:30

Venous Thrombosis IV: Nursing Management

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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Puzzles in practice: splenic vein thrombosis.

Brittany McIntyre1, Melanie Marsh1, Jeffrey Walden1,2

  • 1a Family Medicine Residency , Moses Cone Health System Ringgold standard institution , Greensboro , NC , USA.

Postgraduate Medicine
|May 10, 2016
PubMed
Summary

A 58-year-old man with persistent abdominal pain was diagnosed with splenic vein thrombosis and later pancreatic cancer. This case highlights the importance of considering pancreatic pathology in unexplained abdominal pain, even with initial gastritis diagnosis.

Keywords:
Primary careabdominal imagingabdominal painmedical education

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Area of Science:

  • Gastroenterology
  • Oncology
  • Radiology

Background:

  • Splenic vein thrombosis (SVT) is an uncommon cause of abdominal pain.
  • Pancreatic pathology is a frequent underlying cause of SVT.
  • Persistent abdominal pain warrants a broad differential diagnosis.

Observation:

  • A 58-year-old male presented with epigastric pain, dry heaving, and constipation.
  • Initial diagnosis of gastritis was treated with escalating proton pump inhibitor doses.
  • Computed tomography revealed splenic vein thrombosis with collateral vasculature, suggesting a chronic condition.

Findings:

  • The patient was ultimately diagnosed with biopsy-proven pancreatic cancer.
  • Splenic vein thrombosis was identified as the likely cause of the patient's chronic abdominal pain.
  • Prominent collateral vasculature indicated the chronic nature of the splenic vein thrombosis.

Implications:

  • This case underscores the need to investigate persistent abdominal pain unresponsive to acid-reducing agents.
  • Physicians should consider SVT and pancreatic cancer in the differential diagnosis for unexplained abdominal pain.
  • Red flag symptoms like decreased appetite and weight loss necessitate a thorough workup for abdominal pathology.