Postoperative leg vein thrombosis and pulmonary embolisn after upper abdominal operations. A prospective study with 125I fibrinogentest and pulmonary scintigraphy.

The incidence of postoperative deep venous thrombosis in the lower limbs and of pulmonary embolism has been studied in 49 patients operated upon for gallbladder and gastric diseases. 125I fibrinogen test was performed preoperatively and usually five times postoperatively. Pulmonary scintigraphy was also performed preoperatively and usually twice after the operation. An attempt was made to evaluate the prophylactic effect of Dextran 40. Only one patient developed a deep vein thrombosis without clinical signs. Postoperative pulmonary embolism was found in 13 patients, all but one clinically silent. The second postoperative pulmonary scintigraphy showed that the emboli had disappeared or diminished in 6 patients. Because of the low number of patients with deep venous thrombosis the prophylactic effect of Dextran 40 could not be assessed. The present investigation showed that the incidence of deep venous thrombosis in the legs was low after operations in the upper part of the abdomen while the incidence of pulmonary embolism was high. No connection between leg vein thrombosis and pulmonary embolism could be demonstrated.