A 46-year-old diabetic man complains of soreness of the left leg. He is moderately obese. He had undergone cholecystectomy 2 weeks ago. Examination revealed swelling in the lower leg along with tenderness in the calf that increased when the calf was gently squeezed. No redness of the leg was noted and the patient was a febrile.What is the most likely diagnosis?
A- Cellulitis B- Pressure sores C- Gas gangrene D- Deep vein thrombosis Venous thrombosis, or pathological blood clots within a vein, is a common cause of morbidity and moality. The Virchow triad of venous stasis, hypercoagulability, and vessel wall damage comprise notable risk factors. This patient has several risk factors for DVT- He is obese, diabetic, and has been inactive because of postoperative bed rest, with the latter producing venous stasis. Although gynecological and ohopedic surgeries especially predispose individuals to DVT, any surgery increases the risk. Prevention of DVT includes using lower-limb compression devices during and after surgery. Anticoagulant therapy, such as small-dose heparin, is also sometimes given before surgery and for 1 or 2 days postoperatively. If DVT is confirmed with ultrasound or radiologically with venous contrast (venogram), anticoagulation therapy is impoant to decrease the risk of pulmonary embolism.
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