Deep Venous Thrombosis in an Amputated Limb Stump of a Diabetic Patient: A Case Report

Authors

  • Taoreed A. Azeez Endocrinology Unit, University College Hospital, Ibadan, Nigeria
  • Arionola Esan Endocrinology Unit, University College Hospital, Ibadan, Nigeria
  • Taiwo R. Kotila Haematology Department, University College Hospital, Ibadan, Nigeria

DOI:

https://doi.org/10.17140/DROJ-6-145

Keywords:

Deep venous thrombosis (DVT), Amputated stump, Diabetes patient

Abstract

Deep venous thrombosis (DVT) in an amputated stump is potentially life-threatening but rarely diagnosed and there are limited data
in sub-Saharan Africa. This is aimed at demonstrating an additional vascular risk in patients with lower limb amputation and diabetes.
A 74-year-old man who had a right above knee amputation done on account of grade 5 right diabetic foot with post-operative prophylactic
anticoagulation. Doppler ultrasound done before the surgery showed bilateral multiple lower limb arteries atherosclerosis
but no evidence of deep venous thrombosis. He was discharged home on Zimmer frame. Three months after, he was noticed to
have differential swelling of the right amputation stump. Thigh circumference measured at 15 cm below the anterior superior iliac
spine was 55 cm and 50 cm on the right and left respectively there was but no differential warmth or tenderness. The vital signs were
relatively stable. Doppler ultrasound scan of the lower limbs showed an echogenic thrombus in the right deep femoral vein. He was
commenced on therapeutic dose of subcutaneous enoxaparin. DVT in an amputated stump is uncommonly encountered. It may not
have classical clinical findings. Poor mobility and pooling of venous blood in the amputated stump are some of the risk factors that
have been reported. DVT in an amputated stump in a patient with diabetes is rare and may not present classically. It may be one of
the potential reasons for the increased mortality after lower limb amputation.

References

Bharara M, Mills JL, Suresh K, Rilo HL, Armstrong DG. Diabetes and landmine-related amputations: A call to arms to save limbs. Int Wound J. 2009; 6(1): 2-3. doi: 10.1111/j.1742- 481X.2009.00587.x

Matielo MF, Presti C, Casella IB, Netto BM, Puech-Leão P. Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral ob-structive arterial disease. J Vasc Surg. 2008; 48(6): 1514-1519. doi: 10.1016/j.jvs.2008.07.055

Chong DK, Panju A. Deep venous thrombosis as a cause of stump swelling in two lower extremity amputee patients. Arch Phys Med Rehabil. 1993; 74: 1002-1003.

Buke B, Kumar RR, Vickers V, Grant E, Scremin E. Deep venous thrombosis after lower limb amputation. Am J Phys Med Rehab. 2000; 79 (2): 145-149. doi: 10.1097/00002060-200003000- 00006

American Diabetes Association. Microvascular complications and foot care: Standards of mdical care in diabetes−2020. Diabe-tes Care. 2020; 43(Supplement 1): S135-S151. doi: 10.2337/dc20- S011 Case Report | Volume 6 | Number 1| Diabetes Res Open J. 2020; 6(1): 17-19. doi: 10.17140/DROJ-6-145

Pinar MP, Toledo RP, Castro AH. Deep venous thrombosis (DVT) in lower extremity amputation as a cause of pulmonary embolism. EJCRIM. 2015; 2. doi: 10.12890/2015_000218

Matielo MF, Presti C, Casella IB, Puech-Leao P. Incidence Submit your article to this journal | https://openventio.org/submit-manuscript/ Case Report | Volume 6 | Number 1| Azeez TA et al of ipsilateral post-operative deep vein thrombosis in the ampu-tated lower extremity of patients with peripheral obstructive ar-terial disease. J Vasc Surg. 2008; 48: 1514-1519. doi: 10.1016/j. jvs.2008.07.055

Downloads

Published

2020-07-15

How to Cite

Taoreed A. Azeez, Arionola Esan, & Taiwo R. Kotila. (2020). Deep Venous Thrombosis in an Amputated Limb Stump of a Diabetic Patient: A Case Report. Diabetes Research, 6(1), 17–19. https://doi.org/10.17140/DROJ-6-145