30 JOURNAL AVAILABLE AT RADIOLOGYUPDATE.ORG INTRODUCTION Venous thromboembolism is important social and health care problem, because 20-30 % of pa- tients develop deep vein thrombosis (DVT) afer general surgical operations, while 5.5 % of pa- tients have this complication when laparoscopic fundoplication are performed without appropri- ate prophylaxis [1,2]. Te most frequent reason for pulmonary embolism are thrombi forming in the channels of proximal leg veins and deep pelvic veins. Te development of deep venous thrombosis is related with stasis, hypercoagu- lation state and injury of the venous wall (Vir- chow‘s triad). DIAGNOSTIC INSTRUMENTS FOR DEEP VEIN THROMBOSIS AFTER LAPAROSCOPIC FUNDOPLICATION Indre Zostautiene 1 , Kristina Zviniene 1 ,Mindaugas Kiudelis 2 1 Lithuanian University of Health Sciences, Medicine Academy, Department of Radiology 2 Lithuanian University of Health Sciences, Medicine Academy, Department of Surgery Corresponding email: indrajoss@gmail.com ABSTRACT Background. Deep vein thrombosis remains an important health care problem as it is related with the complications having high morbidity and mortality rate. It is considered the third most common acute cardiovascular disease afer ischemic heart disease and stroke and efects millions of people worldwide. Te aim of this study was to evaluate the rate of deep vein thrombosis (DVT) in patients undergoing laparoscopic fundoplication in two diferent prophylactic regimes and propose the best. To estimate the sensitivity and specifcity of ultrasound (US) for the diagnosis of deep vein thrombosis (DVT) of proximal and distal leg veins. Materials and methods. Te study was performed on 121 patients who were randomized into two groups. All the pa- tients received intermittent pneumatic compression during the laparoscopic fundoplications. Te frst group received low molecular weight heparin 12 h before the operation, 6 and 30 h afer it. Te second group received low molecular weight heparin only 1 h before the laparoscopic fundoplication. All the patients underwent color duplex scan examina- tion preoperatively and spiral CT venography with US scan on the third postoperative day to determine the presence and location of deep vein thrombosis. Results. CT venography revealed posterior tibial vein thrombosis in two (3.3%) I group patients. Te sensitivity and specifcity of US in our study for femoropopliteal DVT, as compared with CT venography, were both 100% and for in- feropopliteal DVT - sensitivity and specifcity 98%. Conclusions. US is highly sensitive and specifc noninvasive imaging option for evaluation of proximal DVT, and it is less accurate for the calf veins. Te better anticoagulation efect was obtained when low molecular weight heparin was administered 1 hour before the laparoscopic fundoplication. DVT usually starts in calf veins, but it may de- velop more proximally and cause life-dangerous pulmonary embolism. 80 - 90 % of pulmonary embolism masses are caused by DVT or a throm- bus formed in the pelvis [3,2]. Laparoscopic sur- gery causes variable serum hypercoagulability; there are data suggesting that the patient de- pendent positioning in combination with intra- operative pneumoperitoneum decreases venous fow from the lower extremities and possibly in- creases the risk of DVT development [4,2]. Te increased intra-abdominal pressure associat- ed with pneumoperitoneum and reverse Trende- lenburg position during laparoscopic fundopli- Keywords: venous thromboembolism, CT venography, sonography.