case_images: PMC10880184_01
case_images: Appearance of right upper extremity on admission.
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case_images: F1
case_images: The patient then developed intractable pain and massive swelling in right upper extremity and further progressed to coldness, cyanosis, paresthesia and paralysis 2 days before admission (Figure 1).
case_images: Ultrasound revealed thrombosis of right subclavian vein (A), axillary vein (B) and cephalic vein (C), as well as right radial, ulnar and part of branchial artery (D).
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case_images: F2
case_images: Duplex ultrasound for upper extremity vessels showed extensive and complete thrombosis of right subclavian vein, axillary vein and distal veins (Figures 2A-C). There were no arterial signals over the right radial, ulnar and part of branchial artery on ultrasound (Figure 2D).
case_images: Lower extremity ultrasound demonstrated occlusive embolism of right common femoral vein (A), bilateral superficial femoral vein (B), right popliteal vein (C) and calf muscular vein (D).
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case_images: F3
case_images: Meanwhile, lower extremity ultrasound demonstrated occlusive embolism of right common femoral vein, bilateral superficial femoral vein, right popliteal vein and calf muscular vein (Figures 3A-D).
case_images: CTPA showed superior vena cava and pulmonary embolism (orange and green arrow, respectively) (A, B), along side with pleural effusion in bilateral chest, especially in right side (C). 3D reconstruction image of CTPA (D).
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case_images: F4
case_images: Computed tomography pulmonary angiography (CTPA) further revealed superior vena cava and pulmonary embolism (PE), alongside with pleural effusion in bilateral chest, especially in right side (Figures 4A-D).