scholarly journals Phlegmasia Cerulea Dolens: A Life- and Limb-threatening Disease

2021 ◽  
Vol 5 (0-2) ◽  
pp. 16
Author(s):  
Wan Nuraisyah Azzahrah Wan Zuki
Keyword(s):  
Venous Thrombosis ◽  
Lower Limb ◽  
Early Recognition ◽  
Vena Cava ◽  
Common Iliac Vein ◽  
Venous Thrombectomy ◽  
Catheter Directed Thrombolysis ◽  
Left Lower Limb ◽  
History Of ◽  
Phlegmasia Cerulea Dolens

Phlegmasia cerulea dolens (PCD) is a rare syndrome caused by venous thrombosis and characterised by a triad of limb oedema, cyanosis and pain. It requires early recognition as delay of treatment can cause gangrene, limb amputation and in extreme cases, death. A 67- year-old Chinese lady, with underlying hypertension, diabetes mellitus and dyslipidaemia presented to the emergency department with a 2 days history of pain, oedema and bluish discoloration over the entire left leg. She had a history of fall 6 months prior and since then she used a walking stick for mobilization. This patient underwent ultrasound doppler left lower limb , which showed features suggestive of long-segment left lower limb deep vein thrombosis. A diagnosis of PCD was made. Subsequently, she went for a CT angiogram and venography of the left lower limb which confirmed thrombosis of the left calf vein extending to the long segment of the left common iliac vein. She was commenced on intravenous heparin infusion and then underwent inferior vena cava filter insertion and catheter directed thrombolysis. Repeat venogram showed successful catheter directed thrombolysis of the left lower limb deep venous thrombosis (DVT). Treatment should be initiated as soon as the diagnosis of PCD is suspected. Currently, guidelines for treatment are lacking however 3 therapeutic options are advocated alone or in combination: anticoagulants, thrombolytic therapy, and venous thrombectomy. An early recognition of PCD and appropriate decision regarding the treatment is essential to preserve the limb.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S16

scholarly journals May-Thurner Syndrome and Recurrent DVT: A Case Report

2020 ◽  
Vol 1 (1) ◽  
pp. 13-16 ◽  
Author(s):  
Neha Tarannum ◽  
H.V.V.S.S. Lakshman K. ◽  
Mohammed Sadiq Azam ◽  
Rajendra Kumar Premchand
Keyword(s):  
Lower Limb ◽  
Vena Cava ◽  
Iliac Vein ◽  
Definitive Treatment ◽  
Common Iliac Vein ◽  
Venous Flow ◽  
Left Common Iliac Vein ◽  
Left Lower Limb ◽  
High Index Of Suspicion ◽  
Variable Condition

May-Thurner syndrome/Cockets syndrome/ileocaval syndrome is a rarely diagnosed, anatomical and pathologically variable condition, causing venous flow obstruction in iliocaval territory. We report a case of 64 year old male patient who presented with unprovoked proximal deep venous thrombosis (DVT) of left lower limb. Evaluated for hypercoagulable state, which was negative, the patient underwent catheter guided thrombolysis and anticoagulation for 6 months. Two years later, he developed left lower limb swelling, and venous doppler revealed acute DVT; CT venogram was consistent with left common iliac vein compression by right common iliac artery suggestive of May-Thurner syndrome. Catheter-guided thrombolysis was done, and percutaneous transluminal peripheral angioplasty/stent was placed from inferior vena cava to left common iliac vein. This case highlights the importance of high index of suspicion in managing patients with DVT for possible ileocaval syndrome wherein anticoagulation alone is insufficient and needs more aggressive and definitive treatment to relieve the obstruction and to prevent recurrence.

A RARE CASE OF MAY- THURNER SYNDROME

2021 ◽  
pp. 17-19
Author(s):  
B. Santhi ◽  
Manigandan Manigandan ◽  
Nishok Nishok
Keyword(s):  
Iliac Artery ◽  
Lower Limb ◽  
Rare Case ◽  
Common Iliac Artery ◽  
Iliac Vein ◽  
Common Iliac Vein ◽  
Middle Aged ◽  
Unique Case ◽  
Left Common Iliac Vein ◽  
Left Lower Limb

May-Thurner syndrome (MTS) is a venous outow obstruction disorder characterized by compression of the left common iliac vein by an overriding right common iliac artery. MTS primarily affects young to middle-aged women, although many patients remain entirely asymptomatic.We report a unique case of a 25 -year-old male who presented with MTS-related multiple varicosities in left lower limb.

Lymphoedema praecox in a young woman: a rare disease

2021 ◽  
Vol 14 (9) ◽  
pp. e245353
Author(s):  
Sri Hari Priya Vemulakonda ◽  
Naveen Kumar Gaur ◽  
Oseen Hajilal Shaikh ◽  
Uday Shamrao Kumbhar
Keyword(s):  
Rare Disease ◽  
Young Woman ◽  
Lower Limb ◽  
Young Age ◽  
Rare Disorder ◽  
Imaging Studies ◽  
Left Lower Limb ◽  
History Of

Primary lymphoedema is a rare disorder. Often presents at a young age with asymptomatic limb oedema with gradual progression. We present a 16-year-old woman who presented with a history of swelling of the left lower limb for 6 years. There was the presence of isolated left lower limb oedema, which was a non-pitting type. The patient underwent imaging studies and was diagnosed to have primary lymphoedema. The patient was managed conservatively as the patient did not have any other problems other than the left lower limb oedema.

scholarly journals A Rare Cause of May-Thurner Syndrome Postarterial Intervention

2019 ◽  
Vol 03 (03) ◽  
pp. 180-184 ◽  
Author(s):  
Hiok Yang Chan ◽  
Edward Tieng Chek Choke ◽  
Tjun Yip Tang ◽  
Chandramohan Sivanathan ◽  
Chua Ming Er Jasmine ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Iliac Artery ◽  
Lower Limb ◽  
Unusual Case ◽  
Anatomical Variation ◽  
Iliac Vein ◽  
Team Approach ◽  
Left Lower Limb ◽  
Iliac Vein Compression

AbstractMay-Thurner syndrome (MTS) is rare condition thought to occur due to an anatomical variation. In MTS, there is left iliac vein compression by the right iliac artery and lumbar spine resulting in left lower limb deep venous thrombosis. The authors report a rare cause of MTS postarterial intervention. They describe the unusual case of an Asian man who presented with acute left lower limb deep venous thrombosis 5 days following left common iliac artery angioplasty and stent insertion. Computed tomographic (CT) venogram demonstrated the left iliac vein compression by the left iliac artery stent. Successful recanalization of the thrombosed iliac vein was achieved with a combination of pulse spray thrombolysis and rheolytic mechanical thrombectomy, followed by angioplasty and stent placement in the iliac vein. There was rapid and complete resolution of symptoms. This report illustrates the use of complementary imaging modalities and a multidisciplinary team approach to achieve a successful technical and clinical outcome following an unusual case of MTS postarterial intervention and the subsequent successful endovascular management.

Catheter-directed thrombolysis for double inferior vena cava with deep venous thrombosis: A case report and literature review

2013 ◽  
Vol 29 (7) ◽  
pp. 480-483 ◽  
Author(s):  
Xiaodong Wang ◽  
Zhengxin Chen ◽  
Qianrong Cai
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Inferior Vena Cava ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Inferior Vena ◽  
Vena Cava ◽  
Catheter Directed Thrombolysis ◽  
Double Inferior Vena Cava

Double inferior vena cava (DIVC) with deep venous thrombosis (DVT) is rare, and there is only one reported case of DIVC with DVT treated by catheter-directed thrombolysis. We report a case of a 32-year-old man with an extensive venous clot involving the infrarenal segment of a double IVC who received filter implantation and catheter-directed thrombolysis.

scholarly journals Multiple CNS Tumors in a Patient With Neurofibromatosis Type 2: Classical Presentation of a Rare Disease

2020 ◽  
Author(s):  
Aamer Ubaid ◽  
Farishta Waheed ◽  
Awais Naeem
Keyword(s):  
Rare Disease ◽  
Lower Limb ◽  
Neurofibromatosis Type ◽  
Neurofibromatosis Type 2 ◽  
Lumbar Region ◽  
Nerve Paralysis ◽  
Function Tests ◽  
Left Lower Limb ◽  
History Of

Neurofibromatosis type 2 is a genetic autosomal dominant disorder caused by a spontaneous mutation in the gene located on chromosome 22 q11-13.1, which usually emerges in adolescence or early adulthood and is characterized by the development of bilateral vestibular schwannoma. We hereby report the classical case of Neurofibromatosis type 2 in a 25-year-old young male with multiple tumors associated with the disease. This patient presented to us with 3 years history of multiple painless nodules on his skin, facial weakness, left-sided progressive hearing loss, and 20 days history of weakness in the left lower limb. On Examination, he was vital with a GCS of 15/15. He was anemic with no jaundice. He had left inguinal lymphadenopathy along with multiple subcutaneous nodules on different areas, including the scalp, face, left mid-axillary line over the abdomen. He also had Right-sided facial palsy and horizontal nystagmus. CNS examination revealed an upgoing plantar on the left side, right facial nerve palsy, and bilateral vestibulocochlear nerve paralysis. Spine examination revealed spinal tenderness in the lower lumbar region. Superficial abdominal reflexes were absent. Upper limb and right lower limb power, tone, and reflexes were normal while the tone and power in the left lower limb were reduced power being ⅗. Reflexes were also exaggerated in the left lower limb. The right ankle showed swelling, most probably a plexiform neuroma. On investigations, he had normochromic normocytic anemia with mild leucocytosis. Platelets were normal. The rest of the biochemical investigations, including serum electrolytes, liver function tests, and renal function tests, were also normal.MRI brain and spine confirmed bilateral acoustic neuroma and multiple cranial and peripheral nerve tumors i.e., classical presentation of a rare disease neurofibromatosis. He was referred to the neurology unit for further assessment and treatment.

scholarly journals Management of Phlegmasia Cerulea Dolens Caused by a Giant Leiomyoma

2021 ◽  
Author(s):  
Elisabeth Ekkel ◽  
Tara Chandran ◽  
Ryan Qasawa ◽  
Michael Trpkovski ◽  
Sachinder Hans
Keyword(s):  
Uterine Leiomyoma ◽  
Inferior Vena ◽  
Mechanical Thrombectomy ◽  
Vena Cava ◽  
Iliac Vein ◽  
Young Female ◽  
Common Iliac Vein ◽  
Venous Obstruction ◽  
Recurrent Thrombosis ◽  
Phlegmasia Cerulea Dolens

Abstract This case is of a young female with a large uterine leiomyoma causing phlegmasia cerulea dolens with thrombosis of the left common and left external iliac veins. She underwent mechanical thrombectomy to temporize the condition until she could be evaluated by gynecology-oncologist to remove the cause of venous obstruction. Prior to hysterectomy, suprarenal inferior vena cava filter was placed. Less than 12 hours post hysterectomy she developed recurrent thrombosis involving the left common and external iliac veins. She underwent repeat mechanical thrombectomy with wall stent placement in the left common iliac vein with resolution of her symptoms.

scholarly journals Progressive encephalomyelitis with rigidity: a paraneoplastic presentation of oat cell carcinoma of the lung. Case report

2004 ◽  
Vol 62 (2b) ◽  
pp. 547-549 ◽  
Author(s):  
Mariana Spitz ◽  
Henrique Ballalai Ferraz ◽  
Orlando G. P. Barsottini ◽  
Alberto Alain Gabbai
Keyword(s):  
Spinal Cord ◽  
Cell Carcinoma ◽  
Lower Limb ◽  
Cranial Nerves ◽  
Muscle Rigidity ◽  
Left Lower Limb ◽  
History Of ◽  
Brain Ct Scan ◽  
Spinal Mri ◽  
Oat Cell Carcinoma

Progressive encephalomyelitis with rigidity and myoclonus (PEWR) is a rare neurological disorder, characterised by muscular rigidity, painful spasms, myoclonus, and evidence of brain stem and spinal cord involvement. A 73-year-old white man was admitted with a 10-day history of painful muscle spasms and continuous muscle rigidity on his left lower limb. He had involuntary spasms on his legs and developed encephalopathy with cranial nerves signs and long tract spinal cord symptomatology. Brain CT scan and spinal MRI were normal. The CSF showed lymphocytic pleocytosis and no other abnormalities. EMG showed involuntary muscle activity with 2-6 seconds of duration, interval of 30-50 ms and a frequency of 2/second in the left lower limb. Anti-GAD antibodies were detected in the blood. We detected radiological signs of lung cancer during the follow-up, which proved to be an oat cell carcinoma. The patient died two weeks after the diagnosis of the cancer.

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