Deep vein thrombosis: A rare complication in oral and maxillofacial surgery: A review of two cases
A 40-year-old woman presented with complaint of pain and swelling in left lower jaw and inability to open the mouth fully for about 6 days. History of trauma (self fall) 6 days ago and there was no history of loss of consciousness with no clinical and radiological evidence of brain injury. There was a history of childhood poliomyelitis. General examination revealed left lower limb paresis. Extra oral examination reveals tenderness in left condylar region, angle of mandible and along the lower border of mandible. Mouth opening was restricted. Intra-orally, occlusion was deranged. Sublingual ecchymosis was present. Left lower teeth were tender on percussion. Left mandibular third molar was fractured. Orthopantomogram revealed left angle and left parasymphysis fracture of mandible []. After thorough clinical and radiographical evaluation patient was diagnosed as suffering from fractured left angle and left parasymphysis of mandible. Routine blood investigations were done and patient was posted for open reduction and internal fixation (ORIF) under general anesthesia (GA). ORIF was done under GA by submandibular approach [] using two, 2 mm 4 hole with gap stainless steel plate and 7 nos. 2 × 8 titanium screws. Duration of surgery was about 45 min. On second post-operative day patient developed mild swelling in right leg which on examination was not tender but of pitting type []. On the 5th day after surgery, swelling became painful and reaches above the knee and calf muscle tenderness was elicited.\nColor duplex Doppler examination of both lower limbs-venous study was performed. Report revealed normal Doppler evaluation of veins of left lower limb and ilio-femoropopliteal deep venous thrombosis in right limb. Patient was referred to vascular surgery unit of higher institute for further management. Now patient is on oral anticoagulant.