Ileofemoral venous thrombosis

A 66-year-old female presented to the emergency department with two-day history of left lower extremity pain and swelling. The pain was described as moderate, localized on the left thigh, groin, and ipsilateral flank. Symptoms were aggravated by standing and walking. She also reported diffuse swelling of the entire left limb and mild redness. There was minimal relief at home with ice packs and leg elevation. She denied fever, chills, chest pain, shortness of breath, diaphoresis, back pain, leg weakness, tingling or numbness. There was no history of deep venous thrombosis (DVT), thrombophilia, bleeding disorders, malignancy or recent trauma. Her medical history includes severe osteoporosis, mitral valve prolapse, breast fibroadenoma, and benign liver cyst. A laparoscopic partial hepatectomy and liver cyst fenestration procedure were performed 4 weeks prior to the onset of her symptoms. She was ambulating immediately after the surgery. Medications included raloxifene and vitamins. Her father had history of myocardial infarction and stroke. There was no family history of DVT or clotting disorders. On physical examination, she was in non-acute distress with normal blood pressure and slightly tachycardic (heart rate 104 beats per minute).