Cervical Rib Causing Thoracic Outlet Syndrome with Left Subclavian Artery and Vein Occlusion, Presenting in 38 Years Old Male: A Clinical Case Report and Its Literature Review

Abstract

Background: Thoracic outlet syndrome is a rare condition secondary to compression of neurovascular bundle in. Being physically active led to better prognosis. Literature shows a strong link between the thoracic and the thoracic area. Introduction: TOS can present with arm pain and swelling, arm fatigue, paresthesia, weakness, and discoloration of the hand. TOS can be classified as neurogenic, arterial, or venous based on the compressed structure(s). Methodology: This is a case presentation of our patient presented to us and was diagnosed with TOS, and then we have written its literature review article on the presentation and management of TOS discussed in PubMed indexed articles. Results and Conclusion: Our patient was timely diagnosed and after managing the acute complication of TOS, such as pain and thrombosis, it was treated with surgical excision of extra rib, since then the patient is asymptomatic. Muscle hypertrophy is recognized as can induce vascular or neurogenic compression outlet syndrome and certain sports.  Neurogenic manifestation is most common, presenting with Pain, numbness, tingling, weakness, and vasomotor changes of upper limb. Vascular complications of thoracic outlet syndrome are uncommon including thromboembolic phenomena and swelling. Both surgical and non-surgical Treatment whereas some non-surgical Treatment appears to be effective in some patients. Despite advances, substantial controversy regarding the diagnosis remains. This is evidenced by the lack of objective findings surrounding TOS, the most common and widely disputed form of TOS. The challenges associated with diagnosis complicate the selection of the appropriate treatment option. In some cases, e.g., acute vascular insufficiency or progressive neurologic dysfunction, surgical decompression is clearly indicated. Prompt recognition and treatment of TOS provide the greatest opportunity for optimal recovery. Unfortunately, the multitude of nonspecific symptoms and challenges in diagnosis can delay treatment and increase the risk of complications. Surgical intervention for TOS syndrome is reserved for patients who have failed conservative management. Conservative treatment including physical therapy need be trialed for at least 4–6 months prior to consideration of surgical intervention.