Managing Multifactorial Deep Vein Thrombosis in an Adolescent: A Complex Case Report

TL;DR

A 17-year-old girl developed deep vein thrombosis after surgery, highlighting the need for personalized care in complex pediatric cases.

Contribution

This case report highlights the management of multifactorial DVT in adolescents with multiple risk factors.

Findings

The patient developed DVT despite anticoagulant therapy due to multiple risk factors.

Interdisciplinary care is crucial for managing complex DVT cases in adolescents.

Standard therapy may not be sufficient for pediatric patients with multiple high-risk factors.

Abstract

Although rarely diagnosed in the pediatric population, deep vein thrombosis (DVT) is experiencing a growing incidence, while continuously acquiring different nuances due to the widening range of risk factors and lifestyle changes in children and adolescents.

A 17-year-old female within four weeks after child delivery was admitted to our clinic due to a six-month history of pain in the left hypochondriac region. After a thorough evaluation, the presence of a benign splenic cyst was revealed, which was later surgically removed. Following the intervention, the patient developed secondary thrombocytosis and bloodstream infection which, together with pre-existing risk factors (obesity, compressive effect of a large cyst, the postpartum period, the presence of a central venous catheter, recent surgery, and post-operative mobilization difficulties) led to the occurrence of extensive DVT, despite anticoagulant prophylaxis and therapy with low-molecular-weight heparin.

DVT raises many challenges for the pediatrician, requiring a personalized approach. Although rare, pediatric patients with multiple concomitant high-risk factors should benefit from interdisciplinary care as DVT may not respond to standard therapy in such cases and rapidly become critical. Continual efforts to better understand and treat this condition will contribute to improved outcomes for pediatric patients affected by DVT.

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