Pulmonary Embolism in A Patient with Superficial Thrombophlebitis-Report of A Case

表淺靜脈栓塞性靜脈炎患者之肺栓塞－一病例報告

劉維新(Wei-Shin Liu) ； 曾炳憲(Bing-Hsiean Tzeng)

《Acta Cardiologica Sinica》 20卷4期 (2004/12) Pp. 241-244

摘要

一位六十二歲女性從一週前右腿開始有輕微腫痛及無法久站或走遠的現象，其後數日又有胸痛、呼吸困難及心悸。之後因昏厥送入本院爭診。最初診斷爲急性冠心症但心導管排除之。由臨床症狀，實驗室及影像學檢查診斷肺栓塞。右下肢的都普勒超音波掃瞄顯示並無深部靜脈栓塞，然而卻發現在大隱靜脈從膝關節附近到股靜脈交界處有栓塞性靜脈炎。經大隱靜脈結紮及抗凝劑治療後，其症狀改善。六個月後之肺部掃瞄顯示正常。我們認爲其肺栓塞最可能的原因是由表淺靜脈栓塞性脈炎所引起，並建議脈曲張合併表淺靜脈炎之病患須攷慮併發肺栓塞之可能性。

關鍵字

靜脈曲張 ； 表淺靜脈栓塞性靜脈炎 ； 肺栓塞 ； 深部靜脈栓塞

並列摘要

A 62-year-old woman presented with mild swelling, pain, and exercise intolerance in the right lower limb for nearly a week; chest pain, dyspnea, and palpitation also subsequently bothered her, and then she suffered 2 attacks of syncope, which prompted hospital admission. Acute coronary syndrome was our impression at first, but emergent coronary angiography did not support this diagnosis. An acute pulmonary embolism was then diagnosed based on the clinical presentation, laboratory data, and imaging findings. Duplex scan of the right lower limb revealed diffuse thrombosis of the great saphenous vein from the saphenous-femoral junction to the level of the knee; the thrombosis was incompressible. However, there was no evidence of deep-vein thrombosis. We supposed that superficial thrombophlebitis might have been the possible etiology of her pulmonary embolism, and suggest that pulmonary embolism may be concurrent in patients with varicose veins and superficial thrombophlebitis.

並列關鍵字

Varicose veins ； Superficial thrombophlebitis ； Pulmonary embolism ； Acute coronary syndrome