Extensive bilateral lower limb deep vein thrombosis following uncomplicated open appendectomy in a young healthy male: a case report.

BACKGROUND

Deep vein thrombosis (DVT) involves blood clots in deep veins, primarily in the lower limbs, with a prevalence of 0.1% annually, more common in elderly men. Open appendectomy, a low-risk procedure for acute appendicitis, typically lasts 30-60 minutes under general anesthesia. Post-surgery, DVT is rare but has been observed in a unique case following an uncomplicated appendectomy, highlighting the need for increased postoperative monitoring for thrombotic complications in low-complexity surgeries.

CASE PRESENTATION: A 26-year-old Arab Iraqi male, BMI 22 kg/m2, presented with 1-day asymmetrical bilateral lower limb swelling and pain, more severe in the right leg, following an uncomplicated appendectomy. No history of prolonged immobilization or previous thromboembolic events was noted. Physical examination revealed bilateral swelling, with right leg circumference 38 cm, and positive Homan's and Moses' signs. Laboratory tests indicated mild hyponatremia, anemia, and elevated inflammatory markers. Doppler ultrasound confirmed extensive acute deep vein thrombosis (DVT) bilaterally. Treatment included bed rest, low-molecular-weight heparin, and later, rivaroxaban for 6 months. Follow-up showed stable thrombus without extension, and thrombophilia screening confirmed no hereditary conditions.

CONCLUSION

A young male developed extensive bilateral lower limb DVT post-appendectomy, highlighting thromboembolic risks in low-complexity surgeries and the need for tailored venous thromboembolism (VTE) prophylaxis and further research.