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Bilateral Upper Extremity DVT in a 43-Year-Old Man: Is It Thoracic Outlet Syndrome?!
[thoracic outlet syndrome]
Recurrent
deep
venous
thrombosis
,
involving
bilateral
upper
extremities
,
is
an
extremely
rare
phenomenon
.
We
are
presenting
a
43
-
year
-old
man
who
was
diagnosed
with
left
upper
extremity
deep
vein
thrombosis
(
UEDVT
)
and
was
treated
with
anticoagulation
and
surgical
decompression
in
2004
.
9
years
later
,
he
presented
with
right
arm
swelling
and
was
diagnosed
with
right
UEDVT
using
US
venous
Doppler
.
Venogram
showed
compression
of
the
subclavian
vein
by
the
first
rib
,
diagnosing
thoracic
outlet
syndrome
(
TOS
)
.
He
was
treated
with
anticoagulation
and
local
venolysis
and
later
by
surgical
decompression
of
the
subclavian
vein
.
Bilateral
UEDVT
,
as
mentioned
above
,
is
an
extremely
rare
condition
that
is
uncommonly
caused
by
TOS
.
To
our
knowledge
,
we
are
reporting
the
first
case
of
bilateral
UEDVT
due
to
TOS
.
Diagnosis
usually
starts
with
US
venous
Doppler
to
detect
the
thrombosis
,
followed
by
the
gold
standard
venogram
to
locate
the
area
of
obstruction
and
lyse
the
thrombus
if
needed
.
The
ultimate
treatment
for
TOS
remains
surgical
decompression
of
the
vascular
bundle
at
the
thoracic
outlet
.
Diseases
Validation
Diseases presenting
"involving bilateral upper extremities"
symptom
thoracic outlet syndrome
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