How Point-of-Care Ultrasound led to a diagnosis of May-Thurner Syndrome

A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory stu...

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Bibliographic Details
Main Authors: Daniel Belkin, Mitchell Belkin, Maedeh Ashrafi, Charan Vegivinti, Yung-Hsien Wang, Leonidas Palaiodimos
Format: Article
Language:English
Published: CINQUILL Medical Publishers Inc. 2021-11-01
Series:POCUS Journal
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Online Access:https://ojs.library.queensu.ca/index.php/pocus/article/view/15105
Description
Summary:A 65-year-old man with a history of a left-sided inguinal hernia presented with three days of left-sided groin pain worsened with exertion and fatigue. The patient was afebrile but tachycardic, and physical examination revealed a tender, erythematous immobile bulge in his left groin. Laboratory studies revealed leukocytosis. Lymphadenopathy secondary to infectious or inflammatory etiology was suspected. However, point-of-care ultrasound (POCUS) identified extensive deep vein thrombosis (DVT) of the lower left limb. Follow-up imaging revealed this to be secondary to May-Thurner syndrome, a mechanical compression of an iliocaval vein against the lumbar vertebrae by a common iliac artery. This report demonstrates how POCUS can be used to identify lower extremity DVT, thereby expediting diagnosis and treatment and potentially preventing complications.
ISSN:2369-8543