THROMBOSIS AND EMBOLISM

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Abstract
On the basis of a series of 40 cases of venous thrombosis, with or without embolic phenomena, an attempt is made to evaluate the various factors responsible for the condition and the means for combating it. The routine methods of prophylaxis were utilized. Embolism was present more often in the patients who were 60 yrs. of age or over than in those in younger age groups. In 70% of the series (28 patients), venous thrombosis occurred after pelvic operations. In 11 of the 17 cases of pulmonary embolism in the group, there was no evidence of a preceding thrombosis or thrombophlebitis, suggesting that in all these cases the emboli arose from silent, deep-seated phlebo-thrombosis. Uncomplicated thrombophlebitis became evident between the 14th and 22d days after operation and phlebothrom-bosis, between the 4th and 14th days. Oicumarol was admd. in 26 of the 30 cases in which there was sufficient time to institute therapy. In addition, heat, elevation of the affected extremity and chemotherapy were utilized. The wisest course is to institute Dicumarol therapy on or about the 5th postoperative day in patients who present factors likely to produce vascular complications, regardless of the smoothness of the convalescence. However, the possibility must be considered that mass prophylaxis might introduce more problems than it would solve.