A Rare Occurrence of Left Radial Vein Thrombosis in A 23- Year-Old Ghanaian Male – A Case Report.

Abstract

The occurrence of upper extremity deep vein thrombosis (UEDVT) is rare. It is usually either diagnosed late or missed entirely, leading to dire complications. It is therefore imperative to highlight the need for clinicians to have a high index of suspicion for UEDVT in patients presenting with upper limb swelling and to emphasize the immense benefit of prompt and effective therapy. We present a case of a 23-year-old Ghanaian male who presented to the University Hospital, Kwame Nkrumah University of Science and Technology with a four-day history of painful swelling of the left forearm a day after the administration of an intravenous bolus of dextrose solution of unknown concentration at a peripheral facility to correct hypoglycaemia. Physical examination revealed a tender swollen left upper limb. The superficial veins were not visible. However, neurovascular examination of the left upper limb was unremarkable. A doppler ultrasound scan showed a nearly 74% occlusion of the left radial vein. A diagnosis of deep vein thrombosis (DVT) of the left upper limb was made. The patient was started on oral rivaroxaban, an anticoagulant, at 15mg twice daily for 21 days, then 20mg daily for 3 months at which a repeat doppler ultrasound scan showed no evidence of a DVT. Early detection of DVT and prompt treatment in patients with upper extremity swelling following an intravenous procedure is crucial as thrombophlebitis may not be the only cause of all such upper limb swellings.