Background: Peripherally inserted central catheters (PICCs) are becoming increasingly popular due to their ease of insertion through upper extremity veins, although they are not complications-free. PICCs can be irritating and cause endothelial injury and inflammation resulting in venous thrombosis. Estimates suggest that more than a third of all deep venous thrombosis (DVT) in the upper […]

Background: Multiple factors can lead to overuse of diagnostic imaging for venous thromboembolism (VTE). These include fear of missing a potentially fatal diagnosis, low predictive accuracy of clinical gestalt, prediction rules, and risk assessment models for VTE, and increased access to imaging. Diagnostic imaging for deep venous thrombosis (DVT) with doppler ultrasonography, or for pulmonary […]

Case Presentation: A 58-year-old-woman with no significant past medical history presented to her primary care physician with bilateral lower extremity edema. She was treated with compression stockings but returned after four months without improvement. She was diagnosed with chronic venous insufficiency and referred to a vascular surgeon for a superficial venous ablation, which was ineffective. […]

Case Presentation: A previously healthy 57-year-old man with a history of chronic sinusitis who received the Ad26.COV2.S vaccination 13 days ago without incident presented to the ED with left lower extremity swelling and pain, left medial thigh ecchymosis, transient episodes of right hand paresthesia and weakness, severe headache with transient blurry vision, and progressively worsening […]

Background: International VTE management guidelines recommend outpatient management for appropriate patients with low-risk deep vein thrombosis (DVT) or pulmonary embolism (PE)[1-3]. Despite the evidence and recommendations, previous studies reported low prevalence of outpatient management, especially for PE[4, 5]. This analysis aimed to characterize trends in outpatient vs. inpatient management of VTE in the last 5 […]

Case Presentation: A 63-year-old woman was initially admitted for sore throat and dysphagia. At that time, workup revealed right parapharyngeal cellulitis, and she completed a 10-day course of levofloxacin. One month after discharge, the patient presented with a bilateral frontotemporal headache, blurred vision OS, and right otalgia for 2 days. Physical exam was remarkable for […]

Case Presentation: A 32 year old male presented to the emergency department unresponsive. Three months prior he had developed urinary incontinence, cognitive impairments, paresthesias in his extremities and weakness requiring crutches. His symptoms progressed leaving him bed bound weeks prior to arrival. EMS was contacted when he became unresponsive to verbal-noxious stimuli and exhibited difficulty […]

Case Presentation: An otherwise healthy 36 year-old presented to the emergency room with increasing pain and swelling of her left upper extremity, progressively worsening over the last week. Physical examination showed significantly enlarged left upper extremity with tenderness and erythema. Further evaluation showed presence of left subclavian, internal jugular vein DVT. A CT-angiogram performed for […]

Case Presentation: A healthy 26-year-old man with no significant past medical history presented to our hospital with right arm pain and swelling for one day. Pain was described as tight pressure with numbness worsening with movement. He had no known inciting trauma but does heavy lifting and plays baseball. He denied family history of venous […]

Case Presentation: A 63-year-old gentleman with a history of unprovoked left lower leg deep vein thrombosis (DVT) on rivaroxaban and seizure disorder on phenytoin, presented with acute onset abdominal pain, hematochezia, vomiting for two days. On presentation patient was tachycardic with a heart rate of 130/min, a physical exam revealed a distended and tender abdomen. […]