Les thromboses veineuses profondes des membres thoraciques chez le s ujet noir africain: à propos de 5 cas observés à L'USERC DU CNHU-HKM de Cotonou

Deep vein thrombosis of the thoracic extremities is rare but severe due to its fatal complication, namely pulmonary embolism. We here report 5 cases of deep vein thrombosis of the thoracic extremities in order to provide a better understanding of this disease affecting African black subjects. Five (5) patients with vein thrombosis of the thoracic extremities documented on venous doppler ultrasound were included in the study between 01/01/2007 and 12/31/2012. The prevalence rate of vein thromboses of the thoracic extremities was 4.09%. The mean age was 48.8 +/- 13.8 years. The sex-ratio was 0.67 in favor of women. It was caused by peripheral venous catheter (40%), cancer (40%) and effort-induced phlebitis (20%). Clinical signs of vein thrombosis of the thoracic extremities were dominated by the edema (100%), pain (80%) and increased heat (80%). The humeral vein was most commonly affected (80% of cases). Complications included postphlebitic sequelae in two (40%) cases, death due to comorbidity in two (40%) cases and pulmonary embolism in one case. The most commonly used protocol was based on heparinotherapy relayed by the anti-vit K (AVK). The mean follow-up after AVK treatment was 44.7 months. Deep vein thrombosis of the thoracic extremities is rare in Cotonou where it is mainly caused by venous catheter and cancer. Prevention of these secondary causes is the best treatment.