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右侧前胸壁疼痛背景下蒙多氏病的诊断

Diagnosis of Mondor's Disease in the Setting of Right-Sided Anterior Chest Wall Pain.

作者信息

Warner Matthew, Durrani Muhammad, Yerram Varsha, Coppa Andrew, Barra Andrew

机构信息

Emergency Medicine, Inspira Medical Center, Vineland, USA.

出版信息

Cureus. 2022 Nov 25;14(11):e31894. doi: 10.7759/cureus.31894. eCollection 2022 Nov.

DOI:10.7759/cureus.31894
PMID:36579201
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9792301/
Abstract

A 60-year-old male patient presented to the emergency department of our hospital with right-sided chest wall pain and a palpable subcutaneous cord-like structure along the right anterior chest wall. Examination revealed tenderness over the cord-like structure, and the skin overlying the structure was freely mobile and did not have any sign of infection or inflammation. Bedside ultrasonography revealed an uncompressible tubular structure with the absence of a color Doppler flow signal. The patient's presentation was suggestive of Mondor's disease. The patient was discharged with instructions to utilize anti-inflammatory drugs, perform warm compresses, and seek primary care follow-up to ensure resolution. Mondor's disease is a rare disorder characterized by a superficial thrombophlebitis of the subcutaneous veins of the chest wall. For its diagnosis, a thorough examination of the patient's medical history and physical condition is suggested; further, the performance of point-of-care ultrasonography has also been suggested. Once recognized, further emergency department workup is typically unnecessary in cases of primary Mondor's disease. Despite being a mostly self-limited condition, greater awareness of this rare disease entity is required to ensure and coordinate close outpatient follow-up as well as monitor resolution due to its association with secondary causes such as vascular and breast carcinoma, vasculitis, and hypercoagulable disorders.

摘要

一名60岁男性患者因右侧胸壁疼痛及沿右前胸壁可触及皮下条索状结构就诊于我院急诊科。检查发现条索状结构处有压痛,其上方皮肤活动自如,无任何感染或炎症迹象。床旁超声检查显示一不可压缩的管状结构,无彩色多普勒血流信号。患者的表现提示为Mondor病。患者出院时医嘱使用抗炎药物、进行热敷,并寻求初级保健随访以确保病情缓解。Mondor病是一种罕见疾病,其特征为胸壁皮下静脉的浅静脉血栓形成。对于其诊断,建议对患者的病史和身体状况进行全面检查;此外,也建议进行床旁超声检查。一旦确诊,原发性Mondor病患者通常无需在急诊科进行进一步检查。尽管该病大多为自限性疾病,但由于其与血管和乳腺癌、血管炎及高凝性疾病等继发性病因相关,需要提高对这种罕见疾病实体的认识,以确保并协调密切的门诊随访以及监测病情缓解情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d230/9792301/bbf5bcfc3c5a/cureus-0014-00000031894-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d230/9792301/bbf5bcfc3c5a/cureus-0014-00000031894-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d230/9792301/bbf5bcfc3c5a/cureus-0014-00000031894-i01.jpg

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本文引用的文献

1
Mondor's disease of the breast: a case series.乳腺蒙多氏病:病例系列
J Med Case Rep. 2021 Apr 2;15(1):188. doi: 10.1186/s13256-021-02708-6.
2
Mondor's Disease: A Review of the Literature.蒙多氏病:文献综述
Intern Med. 2018 Sep 15;57(18):2607-2612. doi: 10.2169/internalmedicine.0495-17. Epub 2018 May 18.
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Mondor disease: a case report in ED.Mondor 病:急诊科 1 例报告。
Am J Emerg Med. 2012 Sep;30(7):1325.e1-3. doi: 10.1016/j.ajem.2011.06.031. Epub 2011 Aug 19.
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[Mondor's disease, report on three cases and literature review].[蒙多氏病:三例报告及文献综述]
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