Archivo Médico de Camagüey (Jun 2019)
Venous thrombosis of unusual site: Paget-Schroetter syndrome
Abstract
Background: venous thromboembolic disease is a frequent clinical illness, associated with multiple risk factors already identified. There are presentations with atypical locations such as thrombosis in the upper limb. The etiology in the 30% of cases is the hypertrophy of the scapular waist muscles (Paget-Schroetter syndrome), which should always be suspected in healthy patients that practice sports to their maximum level, where both pharmacological and surgical treatment will offer an adequate alternative. Objective: to present a young patient with venous thrombosis of unusual site in the upper limb. Presentation of the case: we present the case of a 20-year-old healthy patient, previously a high-performance athlete, who went to consultation for a sub-acute symptomps of inflammatory signs and collateral circulation in the left upper limb, with subsequent confirmation of unusual site venous thrombosis. The common etiologies are ruled out and, finally, scalene hypertrophy known as Paget-Schroetter syndrome is confirmed. Given the duration of the symptoms, the anticoagulation is initially handled and subsequently he is surgically treated with an adequate response. Conclusions: the presence of unusual site venous thrombosis in upper limb in young, healthy and athletic patients forces us to be suspicious about the Paget-Schroetter syndrome as the main etiology allowing the correct handling and prognosis. DeCS: UPPER EXTREMITY DEEP VEIN THROMBOSIS/surgery; UPPER EXTREMITY DEEP VEIN THROMBOSIS/etiology; UPPER EXTREMITY DEEP VEIN THROMBOSIS/diagnosis; UPPER EXTREMITY DEEP VEIN THROMBOSIS/drug therapy; ANTICOAGULANTS/therapeutic use.
