How would you manage suspected SVC obstruction?

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Accepted Answer

Management begins with assessment of severity using an ABC approach, particularly looking for airway compromise, stridor or reduced consciousness; if severe I would escalate urgently to ICU and involve anaesthetics. The next step is urgent contrast-enhanced CT thorax to confirm the diagnosis, identify the level of obstruction and underlying cause. If malignancy is suspected I would involve the lung cancer MDT early; tissue diagnosis remains important before definitive oncological therapy where possible. In patients with significant symptoms, endovascular stenting via interventional radiology is often the most rapid and effective relief. Steroids may be considered when lymphoma is suspected or there is significant airway compromise, though they are not universally indicated. So management involves stabilisation, urgent imaging, early MDT involvement and consideration of stenting or targeted oncological treatment depending on cause.

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