[Incidence and symptomatology of lung embolism in relation to the site of deep venous thrombosis]. / Untersuchungen zur Häufigkeit und Symptomatologie der Lungenembolie in Abhängigkeit von der Lokalisation der tiefen Beinvenenthrombose.

ABSTRACT

The uncertainty about the true incidence of pulmonary embolism (PE) in connection with deep venous thrombosis (DVT) becomes evident when comparing the results of autopsy--vs. clinical studies, with the former showing a three-fold elevated rate of embolisation. In order to evaluate the percentage of clinically inapparent PE, all patients (65 females, 54 males, mean age 61.3 years) hospitalized between April 1989 and March 1990 with suspected DVT and/or PE underwent duplex-sonography and pulmonary scintigraphy. In 108 cases, DVT could be ascertained, whereas 11 patients only suffered from PE. In 57.4% of all DVT, PE was diagnosed. Of the 73 cases with PE, only 53.4% of the patient stated typical symptoms primarily. In more than 1/4 of the patients with primary symptoms of PE, no DVT could be diagnosed. There was no significant difference between the occurrence of PE in relation to the localisation of DVT, with 1/3 to 1/2 being asymptomatic. 1/4 of the patients with leg-thrombosis and 1/7 with thrombosis of the iliac vein did not complain of typical symptoms of thrombosis. Furthermore, an increased PE-rate seems to occur with an elevated ultrasound echogenity of the thrombus. As a result of the study pulmonary szintigrams seem to be indicated in all cases of DVT in order to evaluate the total PE risk.