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Bilateral Upper Extremity DVT in a 43-Year-Old Man: Is It Thoracic Outlet Syndrome?!

Jabri H, Mukherjee S, Sanghavi D, Chalise S - Case Rep Med (2014)

Bottom Line: Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS.To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS.Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Saint Joseph Hospital, Chicago, IL 60657, USA.

ABSTRACT
Recurrent deep venous thrombosis, involving bilateral upper extremities, is an extremely rare phenomenon. We are presenting a 43-year-old man who was diagnosed with left upper extremity deep vein thrombosis (UEDVT) and was treated with anticoagulation and surgical decompression in 2004. 9 years later, he presented with right arm swelling and was diagnosed with right UEDVT using US venous Doppler. Venogram showed compression of the subclavian vein by the first rib, diagnosing thoracic outlet syndrome (TOS). He was treated with anticoagulation and local venolysis and later by surgical decompression of the subclavian vein. Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS. To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS. Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed. The ultimate treatment for TOS remains surgical decompression of the vascular bundle at the thoracic outlet.

No MeSH data available.


Related in: MedlinePlus

Chronic scarring of the right subclavian vein.
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fig3: Chronic scarring of the right subclavian vein.

Mentions: He was started on heparin infusion. After a day of anticoagulation, he had venogram that confirmed right subclavian vein thrombosis (Figures 1 and 2). Percutaneous transluminal balloon angioplasty of subclavian vein showed a narrowing at the level of the thoracic inlet that had an appearance of chronic scarring due to compression (Figure 3). Finally, a pharmacomechanical thrombolysis and thrombectomy were performed.


Bilateral Upper Extremity DVT in a 43-Year-Old Man: Is It Thoracic Outlet Syndrome?!

Jabri H, Mukherjee S, Sanghavi D, Chalise S - Case Rep Med (2014)

Chronic scarring of the right subclavian vein.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129160&req=5

fig3: Chronic scarring of the right subclavian vein.
Mentions: He was started on heparin infusion. After a day of anticoagulation, he had venogram that confirmed right subclavian vein thrombosis (Figures 1 and 2). Percutaneous transluminal balloon angioplasty of subclavian vein showed a narrowing at the level of the thoracic inlet that had an appearance of chronic scarring due to compression (Figure 3). Finally, a pharmacomechanical thrombolysis and thrombectomy were performed.

Bottom Line: Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS.To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS.Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Saint Joseph Hospital, Chicago, IL 60657, USA.

ABSTRACT
Recurrent deep venous thrombosis, involving bilateral upper extremities, is an extremely rare phenomenon. We are presenting a 43-year-old man who was diagnosed with left upper extremity deep vein thrombosis (UEDVT) and was treated with anticoagulation and surgical decompression in 2004. 9 years later, he presented with right arm swelling and was diagnosed with right UEDVT using US venous Doppler. Venogram showed compression of the subclavian vein by the first rib, diagnosing thoracic outlet syndrome (TOS). He was treated with anticoagulation and local venolysis and later by surgical decompression of the subclavian vein. Bilateral UEDVT, as mentioned above, is an extremely rare condition that is uncommonly caused by TOS. To our knowledge, we are reporting the first case of bilateral UEDVT due to TOS. Diagnosis usually starts with US venous Doppler to detect the thrombosis, followed by the gold standard venogram to locate the area of obstruction and lyse the thrombus if needed. The ultimate treatment for TOS remains surgical decompression of the vascular bundle at the thoracic outlet.

No MeSH data available.


Related in: MedlinePlus