DIAGNOSIS AND TREATMENT OF SUPERIOR-VENA-CAVA OBSTRUCTION

Abstract

GRADUAL obstruction of the superior vena cava produces a syndrome which is characterized by venous distention and edema of the head, neck, and upper extremities. This syndrome when fully developed is easily recognized but must be differentiated from those conditions in which there is retardation of right auricular filling, such as occurs in congestive heart failure and pericardial disease. While cardiac disease produces generalized venous hypertension, obstruction of the superior vena cava limits the increased venous pressure to the upper portion of the body. The literature on superior-vena-cava obstruction has been adequately reviewed by McIntyre and Sykes.¹ Between 1904 and 1946 these authors were able to find 145 cases verified by autopsy or surgery. The commonest causes of this syndrome in their patients were primary endothoracic malignant growths, luetic aneurysms, mediastinitis, and localized phlebitis with thrombus formation. A brief discussion of the surgical anatomy of the superior vena cava