Ask a doctor on the topic of Surgery

Differences in treatment with differing medical histories for thrombosis.

May 3, 2016 | 20,00 EUR | answered by Dr. med. Ive Dr. Schaaf

I want to find out what treatment differences arise specifically when the same framework parameters but differences in details in the medical history are present.

Framework facts:
Patient, early 60s, hypertension, obesity, smoker, knee surgery 20 days ago.
Suspicion of acute cholecystitis with the need for emergency cholecystectomy.

Medical history variant at admission 1:
"A thrombosis has not occurred in the patient so far, but in the family."

Medical history variant at admission 2:
"A thrombosis has occurred in both first-degree relatives and in the patient herself in the past."

What important differences arise preoperatively, operatively and postoperatively in the above-mentioned variants of the medical history while adhering to medical standards and the duty of medical care?

Dr. med. Ive Dr. Schaaf

Good morning,
There are no differences, as the combination of nicotine, obesity, and thrombosis in the family already classifies the patient as a high-risk patient. Although the risk is higher if the patient has also experienced a thrombosis themselves, in both cases the patient should be classified as a high-risk patient, leading to a similar treatment approach, including appropriate thrombosis prophylaxis.

Best regards,
Dr. Schaaf