Lee Jonathan B, Kurzweil Ami, Lahham Shadi
University of California, Irvine Medical Center, Department of Emergency Medicine, Orange, California.
Clin Pract Cases Emerg Med. 2020 Aug;4(3):358-361. doi: 10.5811/cpcem.2020.6.47335.
The life- or limb-threatening differential diagnosis for upper extremity swelling can include deep vein thrombosis (DVT), infectious processes, and compartment syndrome. Chronic anatomic abnormalities such as axillary vein stenosis are rarely a consideration in the emergency department.
We present a 26-year-old female with history of Chiari type 1 malformation who presented with acute left arm swelling. Initial workup, including point-of-care ultrasound, revealed the presence of significant soft tissue swelling without evidence of DVT.
Further workup revealed an early, localized rhabdomyolysis secondary to axillary vein stenosis or venous thoracic outlet syndrome, also known as Paget-Schroetter syndrome.
上肢肿胀可能危及生命或肢体的鉴别诊断包括深静脉血栓形成（DVT）、感染性疾病和骨筋膜室综合征。慢性解剖异常，如腋静脉狭窄，在急诊科很少被考虑。
我们报告一名26岁患有1型Chiari畸形的女性，她出现急性左臂肿胀。初步检查，包括床旁超声，显示存在明显的软组织肿胀，但无DVT证据。
进一步检查发现，这是一例继发于腋静脉狭窄或胸廓出口静脉综合征（也称为Paget-Schroetter综合征）的早期局限性横纹肌溶解症。
