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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

Chest X-ray of our patient after right first rib resection.
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fig7: Chest X-ray of our patient after right first rib resection.

Mentions: After the procedure, the patient was put on therapeutic dose of Enoxaparin and he was discharged home on that. A week later he returned to the hospital and had right first rib removal, complete anterior and middle scalenectomy, mobilization and protection of the brachial plexus with external neurolysis of C5-T1 roots, and external venolysis of the left subclavian vein (Figures 4 and 5). Patient was discharged from the hospital on Warfarin after he was seen by a hematologist. He remained asymptomatic and is following up as an outpatient. The procedure and anticoagulation were successful in treating his condition and no recurrence of his condition has been observed in a one-year follow-up (Figure 7).


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)

Chest X-ray of our patient after right first rib resection.
© Copyright Policy
Related In: Results  -  Collection

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

fig7: Chest X-ray of our patient after right first rib resection.
Mentions: After the procedure, the patient was put on therapeutic dose of Enoxaparin and he was discharged home on that. A week later he returned to the hospital and had right first rib removal, complete anterior and middle scalenectomy, mobilization and protection of the brachial plexus with external neurolysis of C5-T1 roots, and external venolysis of the left subclavian vein (Figures 4 and 5). Patient was discharged from the hospital on Warfarin after he was seen by a hematologist. He remained asymptomatic and is following up as an outpatient. The procedure and anticoagulation were successful in treating his condition and no recurrence of his condition has been observed in a one-year follow-up (Figure 7).

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