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

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.