대한정형외과학회지 (Journal of the Korean Orthopaedic Association)

  • 제56권3호
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  • Pages.277-281
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  • 2021
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  • 1226-2102(pISSN)
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  • 2005-8918(eISSN)
대한정형외과학회 (Korean Orthopaedic Association)
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인공 슬관절 전치환술 후 발생한 May-Thurner 증후군

May-Thurner Syndrome after Total Knee Arthroplasty

  • 심창헌 (동아대학교 의과대학 정형외과학교실) ;
  • 박진우 (동아대학교 의과대학 정형외과학교실) ;
  • 왕립 (동아대학교 의과대학 정형외과학교실)
  • Shim, Chang Heon (Department of Orthopaedic Surgery, Dona-A University College of Medicine) ;
  • Park, Jin Woo (Department of Orthopaedic Surgery, Dona-A University College of Medicine) ;
  • Wang, Lih (Department of Orthopaedic Surgery, Dona-A University College of Medicine)
  • 투고 : 2020.04.29
  • 심사 : 2020.06.26
  • 발행 : 2021.06.30
⟨ 이전 논문 다음 논문 ⟩

초록

장골정맥 눌림 증후군으로 알려져 있는 May-Thurner 증후군은 May와 Thurner에 의해 1957년 처음으로 기술되었다. 좌측 하지에서 침습적인 처치 없이 심부 정맥 혈전증의 증상이 나타날 때 May-Thurner 증후군을 의심할 수 있다. 저자들은 우측 인공 슬관절 전치환술 후 좌측 하지의 급작스러운 통증, 부종 및 피부색 변화를 보여 컴퓨터 단층촬영 정맥 조영술 시행 후 May-Thurner 증후군을 진단 받은 중년 여성 환자의 흥미로운 증례를 경험하였다. 본 증례를 통해서 우측 인공 슬관절 전치환술 후 간과할 수 있는 좌측 하지 May-Thurner 증후군을 조기에 진단하여 합병증을 예방하는 데 임상적 의의가 있다고 본다. 이에 문헌 고찰과 함께 증례를 보고하고자 한다.

Iliac vein compression syndrome, which results in thrombosis of the left iliac veins, was first described by May and Thurner in 1957. May-Thurner syndrome should be considered when deep vein thrombosis-like symptoms appear, especially in the left lower extremities without an invasive procedure. The authors encountered an interesting case of a middle-aged female patient, who presented with sudden pain, swelling and skin color changes to the left lower extremity after right total knee arthroplasty and was diagnosed May-Thurner syndrome by computed tomography venography. This case is of clinical significance in that the early diagnosis of May-Thurner syndrome in the left lower extremity was made, which might have been overlooked after right total knee arthroplasty. This case is reported with a review of the literature review.

키워드

과제정보

본 연구는 동아대학교 연구과제 지원으로 이루어졌음.

참고문헌

  1. Kim YH, Yoo JH, Kim JS. Factors leading to decreased rates of deep vein thrombosis and pulmonary embolism after total knee arthroplasty. J Arthroplasty. 2007;22:974-80. https://doi.org/10.1016/j.arth.2007.03.033
  2. Davidson HC, Mazzu D, Gage BF, Jeffrey RB. Screening for deep venous thrombosis in asymptomatic postoperative orthopedic patients using color Doppler sonography: analysis of prevalence and risk factors. AJR Am J Roentgenol. 1996;166:659-62. https://doi.org/10.2214/ajr.166.3.8623645
  3. May R, Thurner J. The cause of the predominantly sinistral occurrence of thrombosis of the pelvic veins. Angiology. 1957;8:419-27. https://doi.org/10.1177/000331975700800505
  4. Kibbe MR, Ujiki M, Goodwin AL, Eskandari M, Yao J, Matsumura J. Iliac vein compression in an asymptomatic patient population. J Vasc Surg. 2004;39:937-43. https://doi.org/10.1016/j.jvs.2003.12.032
  5. O'Sullivan GJ, Semba CP, Bittner CA, et al. Endovascular management of iliac vein compression (May-Thurner) syndrome. J Vasc Interv Radiol. 2000;11:823-36. https://doi.org/10.1016/S1051-0443(07)61796-5
  6. Oguzkurt L, Ozkan U, Tercan F, Koc Z. Ultrasonographic diagnosis of iliac vein compression (May-Thurner) syndrome. Diagn Interv Radiol. 2007;13:152-5.
  7. Baron HC, Shams J, Wayne M. Iliac vein compression syndrome: a new method of treatment. Am Surg. 2000;66:653-5. https://doi.org/10.1177/000313480006600710
  8. Dheer S, Joseph AE, Drooz A. Retroperitoneal hematoma caused by a ruptured pelvic varix in a patient with iliac vein compression syndrome. J Vasc Interv Radiol. 2003;14:387-90. https://doi.org/10.1097/01.RVI.0000058411.01661.2b
  9. Uhl JF, Gillot C, Chahim M. Anatomical variations of the femoral vein. J Vasc Surg. 2010;52:714-9. https://doi.org/10.1016/j.jvs.2010.04.014
  10. Bergen MA, Wall KC, Kim CY, Garrigues GE. Occult left common iliac vein compression increases postoperative venous thromboembolism risk following total hip arthroplasty. J Arthroplasty. 2019;34:375-8. https://doi.org/10.1016/j.arth.2018.10.024