Yang Amy, Seevanayagam Siven
Brian F. Buxton Department of Cardiac and Thoracic Aortic Surgery, Austin Health, Heidelberg 3084, Australia.
J Surg Case Rep. 2023 Aug 9;2023(8):rjad461. doi: 10.1093/jscr/rjad461. eCollection 2023 Aug.
Upper extremity deep venous thrombosis (UEDVT) is rare but carries significant morbidity. Primary UEDVT presents non-specifically and there are no clear diagnostic or management guidelines, which are essential for early treatment to prevent potentially devastating complications such as pulmonary embolus or post-thrombotic pain syndrome. A patient with left brachiocephalic vein UEDVT initially diagnosed radiographically as an acute aortic syndrome and referred to a cardiothoracic unit is presented. Computed tomography venogram confirmed the diagnosis of UEDVT and therapeutic anticoagulation was started. This case highlights the need for validated diagnostic and management algorithms for UEDVT. Furthermore, this relatively rare condition should be considered for patients with acute chest pain and abnormal imaging referred to surgical units.
上肢深静脉血栓形成（UEDVT）较为罕见，但会引发严重的发病情况。原发性UEDVT的表现不具有特异性，且尚无明确的诊断或管理指南，而这些指南对于早期治疗以预防潜在的毁灭性并发症（如肺栓塞或血栓后疼痛综合征）至关重要。本文介绍了一名左头臂静脉UEDVT患者，最初经影像学诊断为急性主动脉综合征，并被转诊至心胸外科。计算机断层静脉造影证实了UEDVT的诊断，并开始进行治疗性抗凝。该病例凸显了针对UEDVT的有效诊断和管理算法的必要性。此外，对于转诊至外科科室的急性胸痛且影像学异常的患者，应考虑这种相对罕见的疾病。
