A study of certain factors in the etiology of thrombophlebitis in the lower extremities following surgery

Abstract

I T is generahv agreed that muItipIe factors participate -in the etiology of thromboembohsm foIlowing surgery. The apparently inconstant presence of such factors may be due, in part, to the Iack of use of known criteria for the diagnosis of periphera1 venous thrombosis.’ In a previous study it was demonstrated that shock and hypotension were present before, during or after surgery in a statisticaIIy significant number of patients who Iater died from puImonary emboIism.2 It was suggested that shock and hypotension might be etiologic factors in thromboembolic disease.2 The present study is concerned with an anaIysis of the possible etiologic roIe of shock and hypotension in postoperative thrombophlebitis. In view of the difficulties often encountered in estabIishing the presence or absence of periphera1 venous thrombosis the present study was Iimited to thrombosis of the veins of the lower extremities, which is reIativeIy easiIy diagnosed by clinica features such as pain, tenderness and sweIIing. It was thus necessary to escIude many patients with suspected but not clinically verifiabIe venous thrombosis occurring in the prostatic veins, the pelvic veins and other areas. Also excIuded were patients stated to have thrombophIebitis of one or both Iower extremities but on whose case records confirmatory cIinica1 findings had not been noted.