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SINDROME DE VENA CAVA SUPERIOR - EXTRANET - Hospital ...

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URGENCIAS<br />

• RX torax<br />

• Doppler venoso local: negativo para trombosis<br />

• Clexane profiláctico<br />

PLANTA<br />

• Corticoides i.v./Oxigenoterapia<br />

• TAC Body Urgente<br />

• ECOCARDIO Urgente D/ Taponamiento<br />

• Toracocentesis diagnóstica (IF)<br />

• PBA por ECO (AP/IF) //TROMBOSIS YUGULAR BILATERAL → AC Clexane SPL<br />

• Rx INTERVENCIONISTA desestima Stent/fibrinolisis<br />

• Traslado a UCI<br />

• → Heparina Na iv + Dexametasona 40 mg i.v./día<br />

• Doppler venoso trombosis de ambas yugulares y subclavias.<br />

• 2ª PBA por ECO (AP/IF) → LNH-B cel. grande difuso alto grado<br />

• TAC/PET: SUV > 20 // BMO<br />

• QT R-Mega-CHOP.<br />

• Pendiente de estudio de hipercoagulabilidad.

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