Odynophagia in sickle cell anemia: pain is not always a crisis.
This report describes the case of a 30-year-old African American male with sickle cell anemia who presented with odynophagia and chest pain. Clinical examination revealed tachypnea, conjunctival congestion, icterus, facial swelling, engorged neck veins, induration over the upper part of chest and arms and a right chest wall port-a-cath. Subsequent imaging revealed occlusion of both brachiocephalic veins and proximal superior vena cava with a metallic SVC stent in-situ. Recanalization was attempted but guidewires could not be passed across the site ofocclusion. He was then treated with catheter guided t-PA boluses delivered to the site of occlusion and oral anticoagulation.
University of Connecticut, Farmington, USA.
Shounak
S
Majumder
D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications*; D000925:Anticoagulants / Q000008:administration & dosage; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging; D002637:Chest Pain / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging
D000925:Anticoagulants