A case report on deep vein thrombosis in a diabetic patient’s amputated limb stump

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 pro phylactic 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.