Pemberton's sign

Pemberton's sign is a clinical sign which is used to diagnose superior vena cava syndrome (SVCS). The sign is named after Hugh Pemberton, a British physician who first described it in 1946.

Definition

Pemberton's sign is defined as facial plethora and/or arm swelling after raising the arms above the head for one minute. This sign is indicative of superior vena cava syndrome (SVCS), a medical condition that occurs when the superior vena cava, the large vein that carries deoxygenated blood from the upper half of the body back to the heart, is obstructed.

Clinical Significance

Pemberton's sign is a useful clinical tool in diagnosing SVCS. The sign is positive when the patient's face becomes red and swollen after raising their arms above their head for one minute. This is due to the obstruction of the superior vena cava, which prevents blood from draining from the upper body, leading to increased pressure and subsequent swelling and redness.

SVCS is most commonly caused by malignancies such as lung cancer and lymphoma, but can also be caused by non-malignant conditions such as thrombosis and mediastinal fibrosis. Early diagnosis of SVCS is crucial as it is often a sign of advanced disease and requires immediate treatment.

Diagnosis

The diagnosis of Pemberton's sign is primarily clinical, based on the patient's symptoms and physical examination. If Pemberton's sign is positive, further investigations are required to confirm the diagnosis of SVCS and to identify the underlying cause. These may include imaging studies such as a chest X-ray, CT scan or MRI, and blood tests to check for markers of malignancy.

Treatment

The treatment of SVCS depends on the underlying cause. In cases where SVCS is caused by a malignancy, treatment options may include chemotherapy, radiation therapy, or surgery to remove the tumor. In cases where SVCS is caused by a non-malignant condition, treatment may involve anticoagulation therapy or procedures to relieve the obstruction.

See Also

• Superior vena cava syndrome
• Hugh Pemberton
• Lung cancer
• Lymphoma
• Thrombosis
• Mediastinal fibrosis

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