Management of Acute Isolated Soleal Vein Thrombosis in a Pregnant Patient With an Osteopathic Approach to Evaluation
The Journal of the American Osteopathic Association
The authors of this case report tackle one of the most debated issues in the field of venous thromboembolism — the management of isolated soleal vein thrombosis. Their patient was a 37-year-old woman with a history of recurrent spontaneous abortions and cervical insufficiency who had a short cervix and acute right isolated soleal vein thrombosis. Somatic dysfunction was found at segments T10-L2, which the authors believe were most likely indicative of viscerosomatic reflexes from the patient’s affected lower extremity. Additional viscerosomatic reflexes were identified at T3-T4, as was an anterior Chapman point on the right at the sternocostal junction in the intercostal space between the fourth and fifth ribs. Both of these findings are specific to lower lung problems, most likely due to acute pulmonary embolism. Somatic dysfunction resulting from pulmonary embolism was also found in the exhalation dysfunction of the third to 10th ribs. Although the authors did not provide osteopathic manipulative treatment, they speculated that an osteopathic approach to managing the patient’s lower-extremity venous thromboembolism and pulmonary embolism may have provided symptomatic relief by means of normalizing the facilitated segments and altered structures. (This hyperlink is to the abstract for «Management of Acute Isolated Soleal Vein Thrombosis in a Pregnant Patient With an Osteopathic Approach to Evaluation.» To view the full article, you will need to log in to the JAOA’s website using your standard AOA username and password.)
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