An Unusual Case of Deep Vein Thrombosis (DVT) after Orthognathic Surgery: A Case Report and Review of Literatures

Publication date: Available online 30 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Sahand Samieirad, Hadi Tohidi, Majid Eshghpour, Mayam Sadat Hashemipour

Abstract

Deep vein thrombosis (DVT) is primarily caused by obstruction of blood flow in the deep veins in the lower limbs. It is a form of thrombophlebitis and can be a major cause of morbidity and mortality in hospitalized patients. This paper aims to report an unusual case of DVT in a 21-year-old female class III patient who underwent bimaxillary orthognathic surgery (BSSO and LeFort I osteotomy) under general anesthesia. She developed DVT unexpectedly one week after the surgery, with episodes of sweating and chills, as well as lower limb edema, tenderness and rigidity. D-dimer lab test and the venous doppler sonography were performed and DVT diagnosis was confirmed; therefore, the patient was admitted to the ICU for anticoagulant and supportive therapy. Although the incidence rate of thromboembolism in the hospitalized patients undergoing oral and maxillofacial surgery is low, it is not a DVT risk-free operation. This complication can potentially cause fatal acute pulmonary thromboembolism and death. This case study illustrated that the pharmacological treatment of menorrhagia with mefenamic acid when combined with intra-operative use of tranexamic acid for control of blood loss might put the patient at an increased risk of DVT. Hence, maxillofacial surgeons should assess all their patients pre-operatively in terms of thromboembolism risk; if they suspect any risk factors in the patient, prompt diagnostic tests and management should be ordered.

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