[Deep venous thrombosis of the upper extremity: a study of 10 cases].

BACKGROUND

Deep venous thrombosis (DVT) of upper limbs is less common than in lower limbs, although an increased prevalence has been observed in recent years.

METHODS

The cases of DVT of upper limbs seen in an internal medicine service during a 24 month period were reviewed. Ten episodes out of overall 103 instances of DVT were identified (9.7%). The diagnosis was confirmed by colour echo-Doppler and/or phlebography. Subcutaneous calcium heparin was subcutaneously given at a dose of 2500 IU per 10 kg of body weight every 12 hours for 7 days, associated with oral anticoagulants given for a variable period in each case.

RESULTS

The predisposing factors were: strenuous physical exercise (2 cases), oral contraceptives (2 cases), C-protein deficiency (1 case), parenteral drug abuse (PDA) (1 case), mediastinal mass (1 case), indwelling catheter (1 case) and absence of an apparent factor (2 cases). The colour echo-Doppler diagnosis was definitive in all cases where the study was carried out (8/10). The response to therapy was favourable in all cases. No case of pulmonary thromboembolism was found and post-phlebitic sequelae did not develop in the patients who could be followed up (6/10).

CONCLUSIONS

The prevalence of deep venous thrombosis of upper limbs is increasing in recent years. The introduction of colour echo-Doppler is a very helpful noninvasive diagnostic procedure. Subcutaneous calcium heparin at the reported dose is a good therapeutic approach.