A Woman With DVT After a Flight, Anemia, and Bowel Changes

Jun H. Lee, MD; Marc D. Basson, MD, PhD


June 29, 2021

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A 66-year-old woman with a history of factor V Leiden thrombophilia presents to the emergency department (ED) with deep venous thrombosis (DVT) after a 6-hour plane flight within the continental United States. During evaluation, she is found to be mildly anemic. Upon further discussion, she reports her bowel movements have increased from once daily to two to three times daily and have become slightly looser than normal over the past month. She also notes that in the past 2 weeks, her abdomen has felt "bloated and hard." She did not notice blood or mucus in her stool and denies pelvic or rectal pain, change in the stool caliber, recent weight loss, regular consumption of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), or any history of stomach ulcers.

The patient is an ex-smoker who is fit for her age and enjoys regular aerobic exercise. She lives alone and has two grown children who live overseas; however, she has not recently traveled abroad. She eats balanced meals, with regular consumption of red meat and vegetables. She takes no regular medications and has never had surgery. She has not been recently ill and has no history of recent antibiotic use. No family history of bowel cancer is noted; one of her daughters was diagnosed with ulcerative colitis as a teenager.


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