ABSTRACT Background Upper extremity deep vein thrombosis (UEDVT) is rare, accounting for 4%–10% of all DVT cases. Central venous catheterization and malignancy are primary risk factors, making cases without these factors uncommon. Case Presentation A 76‐year‐old woman with hypertension was admitted with sepsis. She had no history of central venous catheterization. Contrast‐enhanced CT revealed asymptomatic UEDVT in the left subclavian and brachiocephalic veins, lower extremity DVT, and bilateral pulmonary embolism. D‐dimer was elevated. Tests showed elevated homocysteine; other thrombophilic screening was negative. No malignancy was detected. Heparin followed by edoxaban achieved complete resolution on follow‐up imaging. Conclusions In elderly patients with elevated D‐dimer and multiple DVT risk factors, particularly with sepsis or limited cardiopulmonary reserve, upper extremity imaging may be warranted even without UEDVT‐specific symptoms. Asymptomatic UEDVT may have clinical implications for management.
Uotani et al. (Wed,) studied this question.