163 Phlebitis migrans Instruction Look at this patient’s leg: he has had similar such lesions at different sites at intervals. Salient features History • Time course, pain and tenderness of skin lesions • Ask the patient about: • local trauma (including intravenous infusions) • gastrointestinal malignancies (pancreatic or gastric cancer) • history of oral contraceptives. Examination • Inflamed superficial leg veins. Proceed as follows: Tell the examiner that you would like to investigate for the underlying malignancy, usually carcinoma of the pancreas or stomach (Trousseau’s sign; Fig. 142.1) (N Engl J Med 1992;327:1128–33, N Engl J Med 1994;327:1163–4). Diagnosis This patient has migratory phlebitis (lesion) and I would like to investigate for an underlying pancreatic or gastric malignancy (aetiology). Advanced-level questions In which other condition is superficial phlebitis a prominent sign? Thromboangiitis obliterans (N Engl J Med 2000;343:864). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Phlebitis migrans Full access? Get Clinical Tree
163 Phlebitis migrans Instruction Look at this patient’s leg: he has had similar such lesions at different sites at intervals. Salient features History • Time course, pain and tenderness of skin lesions • Ask the patient about: • local trauma (including intravenous infusions) • gastrointestinal malignancies (pancreatic or gastric cancer) • history of oral contraceptives. Examination • Inflamed superficial leg veins. Proceed as follows: Tell the examiner that you would like to investigate for the underlying malignancy, usually carcinoma of the pancreas or stomach (Trousseau’s sign; Fig. 142.1) (N Engl J Med 1992;327:1128–33, N Engl J Med 1994;327:1163–4). Diagnosis This patient has migratory phlebitis (lesion) and I would like to investigate for an underlying pancreatic or gastric malignancy (aetiology). Advanced-level questions In which other condition is superficial phlebitis a prominent sign? Thromboangiitis obliterans (N Engl J Med 2000;343:864). Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Phlebitis migrans Full access? Get Clinical Tree
