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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 43

Phlebolith with dyspnoea


1 Senior Consultant, Pulmonary & Critical Care Medicine, Apollo First Med Hospitals, Chennai 600 010, Tamil Nadu, India
2 Consultant, Pulmonary & Critical Care Medicine, Apollo First Med Hospitals, Chennai 600 010, Tamil Nadu, India

Date of Submission09-Oct-2019
Date of Web Publication25-May-2021

Correspondence Address:
Meghena Mathew
Consultant, Pulmonary & Critical Care Medicine, Apollo First Med Hospitals, Chennai 600 010, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1732_19

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How to cite this article:
Mani AK, Mathew M. Phlebolith with dyspnoea. Indian J Med Res 2020;152, Suppl S1:43

How to cite this URL:
Mani AK, Mathew M. Phlebolith with dyspnoea. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:43. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/43/316726

Patient's consent obtained to publish clinical information and images.


A 45 yr old male presented to the Emergency department of Apollo First Med Hospitals, Chennai, India, in September 2017, with progressive dyspnoea over two months. He had type-1 respiratory failure. Examination revealed a soft-tissue swelling over the posterior aspect of the right chest wall. Echocardiogram showed severe pulmonary artery hypertension. Computed tomography chest with pulmonary angiogram showed extensive phleboliths in the chest and abdomen region [Figure 1]A with soft-tissue haemangiomata in the chest wall [Figure 1]B and acute-on-chronic pulmonary embolism [Figure 1]C. He was started on oral anticoagulation with rivaroxaban after the diagnosis in the same admission and continued till April 2019 and showed clinical improvement. This is a rare case of Klippel-Trenaunay syndrome. It is a congenital condition associated with soft-tissue hypertrophy and vascular malformations. The patient was on regular follow up on until April 2019. He had clinical improvement except for minimal dyspnea on exertion. His repeat CT in April 2019 showed chronic pulmonary thromboembolism predominantly in the right lung.
Figure 1: (A) CT chest with pulmonary angiogram showed extensive phleboliths in the chest and abdomen (arrow). (B) Haemangiomata over the right posterolateral chest wall (arrow) in CTPA. (C) Thrombus in the left lobar pulmonary artery (arrow).

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Conflicts of Interest: None.


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