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Lower Extremity Deep Venous Thrombosis with Fatal Pulmonary Thromboembolism Caused by Benign Pelvic Space-Occupying Lesions—An Overview

Authors

  • Hannah Rosenfeld,

    1. The University of Adelaide Medical School, Frome Road, Adelaide, SA 5005, Australia.
    2. Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia.
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  • Roger W. Byard M.D.

    1. The University of Adelaide Medical School, Frome Road, Adelaide, SA 5005, Australia.
    2. Forensic Science SA, 21 Divett Place, Adelaide, SA 5000, Australia.
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Additional information and reprint requests:
Professor Roger W. Byard, M.D.
Discipline of Anatomy and Pathology
Level 3 Medical School North Building
The University of Adelaide
Frome Road
Adelaide
SA 5005
Australia
E-mail: roger.byard@sa.gov.au

Abstract

Abstract:  Venous stasis predisposes to thrombosis. One hundred and sixty cases of fatal pulmonary thromboembolism were reviewed to determine how many cases had deep venous thromboses associated with venous blood flow reduction caused by external pressure from benign pelvic masses. Three cases were identified, representing 2% of cases overall (3/160): a 44-year-old woman with a large uterine leiomyoma (1048 g); a 74-year-old man with prostatomegaly and bladder distension (containing 1 L of urine); and a 70-year-old man with prostatomegaly and bladder distension (containing 3 L of urine). Although a rare cause of fatal deep venous thrombosis and pulmonary thromboembolism, space-occupying pelvic lesions can lead to extrinsic pressure on adjacent veins reducing blood flow and causing stasis and thrombosis. Individuals with large pelvic masses may, therefore, be at increased risk of pulmonary thromboembolism from deep venous thrombosis, particularly in the presence of concurrent risk factors such as immobility, thrombophilias, malignancy, and significant cardiopulmonary disease.

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