Musi Martin E, Melher Abigail, Bromfield Alexander, Rochon Paul J, Davis Christopher B
Emergency Department, University of Colorado, Aurora, CO.
Emergency and Internal Medicine Department, University of Colorado, Aurora, CO.
Wilderness Environ Med. 2020 Sep;31(3):344-349. doi: 10.1016/j.wem.2020.05.001. Epub 2020 Aug 6.
Upper extremity injuries are common among the growing population of climbers. Although conditions affecting musculoskeletal structures are the most common causes of symptoms, a comprehensive differential diagnosis is necessary to avoid the misdiagnosis of high-morbidity conditions in this patient population. We present a case of a climber with acute edema, erythema, and pain of the entire right upper extremity. After confirmation of an upper extremity deep vein thrombosis by ultrasound, and in the absence of secondary causes for his thrombotic process, he was diagnosed with effort thrombosis. The patient was treated acutely with anticoagulation, catheter thrombectomy, direct thrombolysis, and balloon angioplasty followed by surgical decompression of the subclavian vein. Owing to the importance of early diagnosis and initiation of treatment, it is critical to keep disorders affecting the upper thoracic vascular structures in consideration.
在上肢不断增加的攀岩人群中，上肢损伤很常见。尽管影响肌肉骨骼结构的病症是症状的最常见原因，但进行全面的鉴别诊断对于避免误诊该患者群体中高发病率的病症很有必要。我们报告一例攀岩者病例，其右上肢出现急性水肿、红斑和疼痛。经超声确认上肢深静脉血栓形成，且其血栓形成过程无继发原因后，他被诊断为用力性血栓形成。该患者接受了抗凝、导管血栓切除术、直接溶栓、球囊血管成形术等急性治疗，随后对锁骨下静脉进行了手术减压。鉴于早期诊断和治疗启动的重要性，考虑影响上胸部血管结构的疾病至关重要。
