Establishment of venous collateral circulation

Introduction The establishment of the collateral circulation is related to the location of the superior vena cava obstruction. After the blood flow of the main blood vessel (artery or vein) of a part of the body is blocked, the blood vessels of the original anastomotic branch of the part are dilated, forming a bypass, and the blood is bypassed through these bypasses, and the circulation is restored. It is called collateral circulation and is also called compensatory cycle. The causes of obstruction of the superior vena cava are as follows: thrombosis, fibrosis, external compression, tumor invasion, etc., with benign diseases and malignant diseases.

Cause

The causes of obstruction of the superior vena cava are as follows: thrombosis, fibrosis, external compression, tumor invasion, etc., with benign diseases and malignant diseases. The superior vena cava compression syndrome caused by malignant tumors often occurs on the basis of factors such as tumor compression and infiltration. It can be seen that the most common cause of superior vena cava compression syndrome is lung cancer, especially small cell lung cancer, followed by lymphoma, while other tumors are rare.

an examination

Related inspection

Laboratory examination of fungal infections

Diagnosis: The superior vena cava compression syndrome is easily diagnosed when typical signs and symptoms appear. When the superior vena cava compression syndrome is not typical, the occlusion site and cause should be determined by means of angiography and radionuclide venography. CT-enhanced scanning is a commonly used method, and MRI is also available to show lumps, thrombi, and collateral circulation. X-ray examination is the most commonly used, and Parish et al reported chest X-ray findings of 80 cases of superior vena cava compression syndrome: upper mediastinal widening accounted for 64%, pleural effusion accounted for 26%, right hilar mass accounted for 12%, pneumonia infiltration Accounted for 7%, paratracheal lymph node accounted for 5%, mediastinal mass accounted for 3%, chest X-ray showed normal 16%. The superior vena cava compression syndrome often occurs during the progression of the tumor. In most cases, the etiological diagnosis is easier, but the diagnosis of a small number of patients is more difficult. In clinical work, the etiology should be diagnosed first. In the case of difficult diagnosis of the cause, there should be sufficient clinical evidence before treatment. Otherwise, anti-tumor treatment should not be performed.

Laboratory examination: When the malignant tumor is infected, the white blood cells are elevated.

Other ancillary examinations: X-ray examination is the most common: mediastinal widening, right hilar mass, and a small number of pneumonia infiltrates.

Differential diagnosis

(a) bronchial lung cancer

(two) malignant lymphocytosis

(three) mediastinal tumor

(4) Chronic fibrous mediastinal inflammation

(5) Ascending aortic aneurysm

(6) Superior vena cava thrombosis

Diagnosis: The superior vena cava compression syndrome is easily diagnosed when typical signs and symptoms appear. When the superior vena cava compression syndrome is not typical, the occlusion site and cause should be determined by means of angiography and radionuclide venography. CT-enhanced scanning is a commonly used method, and MRI is also available to show lumps, thrombi, and collateral circulation. X-ray examination is the most commonly used, and Parish et al reported chest X-ray findings of 80 cases of superior vena cava compression syndrome: upper mediastinal widening accounted for 64%, pleural effusion accounted for 26%, right hilar mass accounted for 12%, pneumonia infiltration Accounted for 7%, paratracheal lymph node accounted for 5%, mediastinal mass accounted for 3%, chest X-ray showed normal 16%. The superior vena cava compression syndrome often occurs during the progression of the tumor. In most cases, the etiological diagnosis is easier, but the diagnosis of a small number of patients is more difficult. In clinical work, the etiology should be diagnosed first. In the case of difficult diagnosis of the cause, there should be sufficient clinical evidence before treatment. Otherwise, anti-tumor treatment should not be performed.

Laboratory examination: When the malignant tumor is infected, the white blood cells are elevated.

Other ancillary examinations: X-ray examination is the most common: mediastinal widening, right hilar mass, and a small number of pneumonia infiltrates.

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