26yo male presented with a swollen and tender L leg after 6 hour spinal surgery 2 weeks prior. Clinically his left leg was bigger circumferentially than the right. He had dilated superficial veins and pitting oedema. It was obviously a DVT.
ED US showed a DVT in the CFV extending to the popliteal vein.
The patient was referred to haematology due to ongoing pain in the leg and inability to mobilise. Haematology arranged for the patient to have intravascular thrombolysis due to the high risk of PE and post thrombotic syndrome with such extensive proximal DVT.
L groin. L femoral vein is not compressing (left of screen). Hyperechoic clot is seen in the lumen.