Korean J Crit Care Med.  2013 Feb;28(1):59-63. 10.4266/kjccm.2013.28.1.59.

Management of Upper Extremity Deep Vein Thrombosis with a Superior Vena Cava Filter - A Case Report -

• Kwon W
• Ryu HG
• Lee H
• Yoo Y

• KMID: 2227913
• DOI: http://doi.org/10.4266/kjccm.2013.28.1.59

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.

Keyword

pulmonary embolism; superior vena cava; upper extremity deep vein thrombosis; vena cava filter

MeSH Terms

Acalculous Cholecystitis
Chest Pain
Cholecystectomy
Dyspnea
Esophageal and Gastric Varices
Hematemesis
Heparin
Humans
Liver Cirrhosis
Male
Postoperative Care
Pulmonary Embolism
Splenectomy
Upper Extremity
Upper Extremity Deep Vein Thrombosis
Vena Cava Filters
Vena Cava, Superior
Warfarin
Heparin
Warfarin