Clinical Case Database / Category: Patient Management
Management of arterial thoracic outlet syndrome
Publication details
Z Makzal MBBS, I Williams MD, FRCS
Foundation Years Journal, volume 7, issue 5, p.38 (123Doc Education, London, May 2013)
Abstract
This article discusses a case of thoracic outlet syndrome (TOS) complicated by arterial compression in a 40 year old man. This condition requires a high index of suspicion to diagnose, with many patients misdiagnosed for several years. This article further considers the clinical features, investigations and management of TOS. With appropriate multi-disciplinary team (MDT) input and tailored therapy, symptoms can be managed successfully with good outcomes.
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Authors
Z Makzal MBBS
Foundation Year Doctor
University Hospital of Wales, Heath Park, Cardiff
makzal@hotmail.com
I Williams MD, FRCS
Consultant Vascular Surgeon
University Hospital of Wales, Heath Park, Cardiff
References
1. Cronenwett JL, Wayne Johnston K. Rutherford’s Vascular Surgery, 7th edition. Philadelphia: Saunders 2010, 1865-1877.
2. Sanders RJ, Roos DB. The surgical anatomy of the scalene triangle. Contemp Surg 1989; 35:11-16
3. Brewin J, Hill M, Ellis H. The prevalence of cervical ribs in a London population. Clin Anat. 2009 22(3):331-6
4. Sanders RJ, Hammond SL. Management of cervical ribs and anomalous first ribs causing neurogenic thoracic outlet syndrome. J Vasc Surg 2002: 36:51-56.
5. Cronenwett JL, Wayne Johnston K. Rutherford’s Vascular Surgery, 7th edition. Philadelphia: Saunders 2010, 1908-1909.
6. Urschel HC Jr, Razzuk MA. Neurovascular compression in the thoracic outlet: changing management over 50 years. Ann Surg. 1990;228:609-617
7. Schroeder WE, Green FR. Phrenic nerve injuries; report of a case, anatomical and experimental researches, and critical review of the literature. Am J Med Sci 1902: 123:196-220
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Conflict Of Interest
The Journal requires that authors disclose any potential conflict of interest that they may have. This is clearly stated in the Journal’s published “Guidelines for Authors”. The Journal follows the Guidelines against Conflict of Interest published in the Uniform Requirements for Manuscripts Submitted to Biomedical Journals (http://www.icmje.org/urm_full.pdf).
Financial Statement
The authors of this article have not been paid. The Journal is financed by subscriptions and advertising. The Journal does not receive money from any other sources. The decision to accept or refuse this article for publication was free from financial considerations and was solely the responsibility of the Editorial Panel and Editor-in-Chief.
Patient Consent statement
All pictures and investigations shown in this article are shown with the patients’ consent. We require Authors to maintain patients’ anonymity and to obtain consent to report investigations and pictures involving human subjects when anonymity may be compromised. The Journal follows the Guidelines of the Uniform Requirements for Manuscripts (http://www.icmje.org/urm_full.pdf). The Journal requires in its Guidelines for Authors a statement from Authors that “the subject gave informed consent”.
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When reporting experiments on human subjects, the Journal requires authors to indicate whether the procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the HelsinkiDeclaration of 1975, as revised in 2008.
About the Clinical Cases Database
The Foundation Years Clinical Cases Database is a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.
The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.