[Paget-von Schroetter syndrome as an occupational accident].
METHODS
Two men and one woman developed typical symptoms of a thrombosis in the arms after unusual physical effort at their work place (a coal miner after a bad fall, a radiographer after having to catch a patient, a painter after jerkily moving a heavy piece of furniture).


METHODS
In all three patients a thrombosis of the subclavian vein was demonstrated by duplex scans or phlebography. In two patients tests for hypercoagulability were unremarkable. None of the patients had a thoracic outlet syndrome.


METHODS
After initial local thrombolytic or heparin therapy alone, phenprocoumon treatment over several months was given in two cases, and in one case low-molecular-weight heparin was administered over several months. All three patients complained of strain-related residual symptoms in the affected arm (pain, swelling, easy fatigability). In all three cases, the accident insurer recognized the incident to be a work-related accident.


CONCLUSIONS
Patients with a Paget-Schroetter syndrome resulting from a sudden and unusual physical effort at work, which is covered by statutory accident insurance, must be reported to the accident insurer as a work-related accident in order to safeguard individual medical claims of the patient and for general medical and epidemiological reasons.
Zell
L
L
EnBW Energie Baden-Württemberg AG, Arbeitsmedizinischer Dienst, Karlsruhe. l.zell@enbw.com
Scheffler
P
P
Heger
M
M
Buchter
A
A
D000062:Accidents, Occupational / Q000191:economics; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001367:Axillary Vein; D003032:Coal Mining; D004359:Drug Therapy, Combination; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006282:Health Personnel; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D007346:Insurance, Accident; D008297:Male; D010644:Phenprocoumon / Q000627:therapeutic use; D010690:Phlebography; D013350:Subclavian Vein; D013577:Syndrome; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000191:economics / Q000209:etiology*
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006493:Heparin; D010644:Phenprocoumon