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[Retroesophageal hematoma with severe dysfagia after streptokinase for the treatment of the axillosubclavian vein thrombosis].

Authors: A C, Baruzzi; M E, Gadelha; C, Cirenza; E, Knobel;

[Retroesophageal hematoma with severe dysfagia after streptokinase for the treatment of the axillosubclavian vein thrombosis].

Abstract

We report the case of a 72 year-old man with advanced, stage IV, prostate cancer who underwent osteosynthesis of the cervical spine for nerve root decompression due to metastasis which was causing severe pain in his right upper limb. After three months in the hospital, he developed occlusive thrombosis of the right axillosubclavian vein as a complication of prolonged catheterization of the right subclavian vein for treatment of septicemia secondary to a hospital acquired pneumonia. The patient received thrombolytic therapy with IV streptokinase in the contralateral arm in the following dosage: 250,000 units in 15 minutes followed by 100,000 units per hour during five days. This led to total recanalization of the thrombus, with significant reduction of the arm edema. Twenty-four hours after the end of the thrombolytic therapy, the patient started to complain of dysfagia to solids and liquids and a contrasted esophagogram revealed extensive extrinsic compression of the esophagus due to a probable retroesophageal hematoma. The patient required enteral nutrition via nasoenteral tube during three months after which swallowing returned to normal and a repeat upper GI series confirmed that the hematoma had been reabsorbed, with normal passage of contrast through the esophagus. On late follow-up, the patient did not show evidence of any sequelae of deep venous thrombosis nor any residual dysfagia and is currently in use of elastic stockings and low molecular weight heparin.

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Keywords

Male, Hematoma, Thrombosis, Esophageal Diseases, Subclavian Vein, Severity of Illness Index, Fibrinolytic Agents, Humans, Streptokinase, Axillary Vein, Deglutition Disorders, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
Average
Average
gold
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