Management of Upper Extremity Deep Vein Thrombosis witha Superior Vena Cava Filter -A Case Report-
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Upper extremity deep vein thrombosis (UEDVT) is relatively uncommon and superior vena cava (SVC) filter placements are not often encountered due to strict indication. A 33-year old male with underlying protein C/S deficiency and secondary liver cirrhosis was admitted because of hematemesis. The patient was conservatively managed, but underwent elective splenectomy to prevent aggravation of gastric varix. During postoperative care, the patient underwent cholecystectomy for acalculous cholecystitis. During the postoperative course, UEDVT was detected and heparinization was initiated. The patient experienced repeated attacks of severe dyspnea, which was accompanied by chest pain that lasted for 3 to 10 minutes. Repeated episodes of pulmonary thromboembolism were suspected and SVC filter was placed. Warfarin treatment was initiated and the SVC filter was removed about one month later. The case highlights the clinical significance of UEDVT and reports rare case of SVC filter placement. Intensivists should have comprehensive understanding of UEDVT and its management.
Abstract
Upper extremity deep vein thrombosis (UEDVT) is relatively uncommon and superior vena cava (SVC) filter placements are not often encountered due to strict indication. A 33-year old male with underlying protein C/S deficiency and secondary liver cirrhosis was admitted because of hematemesis. The patient was conservatively managed, but underwent elective splenectomy to prevent aggravation of gastric varix. During postoperative care, the patient underwent cholecystectomy for acalculous cholecystitis. During the postoperative course, UEDVT was detected and heparinization was initiated. The patient experienced repeated attacks of severe dyspnea, which was accompanied by chest pain that lasted for 3 to 10 minutes. Repeated episodes of pulmonary thromboembolism were suspected and SVC filter was placed. Warfarin treatment was initiated and the SVC filter was removed about one month later. The case highlights the clinical significance of UEDVT and reports rare case of SVC filter placement. Intensivists should have comprehensive understanding of UEDVT and its management.
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