Vascular filling of the chest wall

Introduction Thoracic vascular filling is one of the clinical manifestations of superior vena cava compression syndrome. In a group of 371 cases of superior vena cava compression syndrome, clinical manifestations reported that the chest wall vascular filling accounted for 54%. The symptoms and signs of the superior vena cava compression syndrome are related to the compression time and the compression site. The time is short, the degree of obstruction is heavy, and the condition is often severe. On the contrary, the condition is milder. Clinical symptoms include cough, headache, head swelling, nausea, vision changes, difficulty in hoarseness, convulsions, and so on.

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

Angiography central venous pressure measurement (CVP)

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.

Differential diagnosis

To be associated with various inflammations leading to intimal hyperplasia of the thoracic wall vein, narrowing of the lumen, and rapid identification of blood flow.

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.

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