Shovman O, George J, Shoenfeld Y
Dept. of Medicine B, Chaim Sheba Medical Center, Tel Hashomer and Sackler Faculty of Medicine, Tel Aviv University.
Harefuah. 1997 Dec 15;133(12):610-2, 663.
Subclavian vein thrombosis accounts for approximately 1-2% of recorded deep venous thromboses. It may be primary or secondary, and insertion of a central venous catheter is the most common cause of secondary subclavian vein thrombosis. Traumas, anatomic abnormalities and carcinoma are important additional risk factors for secondary thrombosis. Primary thrombosis of the subclavian veins is known as Paget-Schroetter syndrome. New criteria for its diagnosis include a history of increased upper extremity use prior to onset of symptoms, the presence of a venographically demonstrated thrombus and absence of any definable causes. We describe a 42-year-old woman with a history of intensive physical exertion admitted with swelling, pain and difficulty moving her arm. The diagnosis of primary subclavian vein thrombosis was established from the history of physical effort, results of Doppler ultrasound, and exclusion of other causes of subclavian vein thrombosis. This case suggests that primary subclavian vein thrombosis should be considered in young patients with subclavian vein thrombosis after exclusion of secondary disease.
锁骨下静脉血栓形成约占已记录的深静脉血栓形成的1%-2%。它可以是原发性的或继发性的,而中心静脉导管插入是继发性锁骨下静脉血栓形成最常见的原因。创伤、解剖学异常和癌症是继发性血栓形成的重要额外危险因素。锁骨下静脉的原发性血栓形成被称为佩吉特-施罗特综合征。其诊断的新标准包括症状出现前上肢使用增加的病史、静脉造影显示有血栓以及不存在任何可明确的病因。我们描述了一名42岁有高强度体力活动史的女性,因手臂肿胀、疼痛和活动困难入院。根据体力活动史、多普勒超声检查结果以及排除锁骨下静脉血栓形成的其他原因,确诊为原发性锁骨下静脉血栓形成。该病例表明,在排除继发性疾病后,年轻的锁骨下静脉血栓形成患者应考虑原发性锁骨下静脉血栓形成。