Paget-von Schroetter syndrome: Case report

Int J Surg Case Rep. 2021 Nov:88:106509. doi: 10.1016/j.ijscr.2021.106509. Epub 2021 Oct 16.

Abstract

Introduction: Paget-von Schroetter Syndrome is a rare condition, which refers to primary venous thrombosis of the subclavian-axillary bed. It is related to vigorous activities involving the upper limbs, presenting pain, edema and muscle swelling. Its diagnosis involves, besides the clinical suspicion, Doppler ultrasonography and should be performed early to ensure immediate treatment. The therapy is initially made with anticoagulation, but thrombolysis, decompression surgery, venolysis and venoplasty should be considered, which can lead to a better prognosis and lower risk of complications.

Case report: This article refers to a report of a male patient, with a history of physical activity, who developed thrombosis in the left upper limb and evolved, after anticoagulant treatment, to post-thrombotic syndrome.

Discussion: Paget-von Schroetter syndrome can be asymptomatic, but common features include hyperemia, edema, heaviness and pain in the affected arm, usually 24 h after the initial event and may be accompanied by low fever. In diagnostic investigation, imaging exam is essential. Early diagnosis of the syndrome allows the early start of treatment, leading to better results and prognosis.

Conclusion: Therefore, this study has the goal of making the diagnosis more effective and improves the clinical-surgical management, from the increase in the level of medical professionals' suspicion regarding the disease.

Keywords: Paget-von Schroetter; Primary thrombosis; Thrombosis.