Inferior vena cava ivc thrombosis is a rare but significant complication in hospitalized patients. We present a case of newly diagnosed kilt syndrome in an 11yearold girl presenting with pain and problems with ambulation. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra. Treatment resulted in complete resolution of the svcs symptoms. A congenitally absent inferior vena cava ivc is a rare condition that is recognized. Vena cava inferior thrombosis detected by venous hum. Jan 31, 2015 behcets disease bd is a rare vasculitis in subsaharan africa. Although the condition is considered rare, case reports have.
Inferior vena cava filters are being used at an increasing rate to prevent venous thromboembolism in a variety of clinical scenarios 1. Dec 16, 2015 inferior vena cava filter thrombosis was observed in 26200 patients % and represented nearly half 45. Although these devices reduce the risk of pulmonary embolism, ivc filters increase the risk of other complications. Inferior vena cava thrombosis american journal of roentgenology. However, it is not clear whether early recognition of. Retrospectively, as discussed in this case, there can be clues indicating the presence of such an anomaly from a young age.
Duplications of the inferior vena cava ivc are seen with an incidence of 0. However, relevant information regarding ivc thrombosis, especially on its morphology, remains scarce. Duplications causing symptoms are rare, with only six reported cases of ivc duplication associated with a deep venous thrombosis. The only vena cava thrombosisrelated fatality presented with phlegmasia cerulea dolens and abdominal compartment syndrome. Extensive bilateral lower extremity deep vein thrombosis. Duplication of inferior vena cava ivc is a rare finding in radiologic studies. This animal model of venous thrombosis allows investigators to study inflammatory interactions between the vein wall and the occlusive venous thrombus. Thrombosis of the inferior vena cava is less common than deep venous thrombosis of the lower extremities, particularly in the absence of an obvious congenital caval abnormality or hypercoagulable state. Percutaneous treatment of superior vena cava syndrome. How is an inferior vena cava ivc filter used to treat deep.
Due to the substantial increase in the number of ivc filters placed in the united states and the very low filter. Anomalies of the inferior vena cava in patients with deep venous. Inferior vena cava, venous thrombosis vena cava filter, computed tomography background vena cava filters have been increasingly used in patients with lowerextremity deep venous thrombosis dvt to avoid pulmonary embolism 1. The renal veins were localized and the cordis filter was implanted in an infrarenal location in the inferior vena cava. Massive inferior vena caval thrombosis radiology case. The diameter of inferior vena cava ivc and thrombusburden formation at day 2 after deep vein thrombosis dvtinducing procedure n 8. A congenitally absent inferior vena cava ivc is a rare anomaly that is recognised to be associated with idiopathic deep venous thrombosis dvt, particularly in the young. Thrombosis of the inferior vena cava postgraduate medical. Idiopathic thrombosis of the inferior vena cava and.
To determine, during heparin therapy, the embolic risk associated with acute inferior vena cava throm bosis compared with noncaval. Thrombosis of the superior vena cava sciencedirect. Prompt recognition and treatment are crucial to avoid more severe outcomes. A vena cava filter is a treatment for an acute blood clot in the leg deep vein thrombosis or lung pulmonary embolism. Mr imaging in inferior vena cava thrombosis sciencedirect. Etiology and treatment of acute inferior vena cava thrombosis. Multisegmental anomaly of the inferior vena cava with.
Inferior vena cava filter undergraduate diagnostic. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. Recurrent deep venous thrombosis and inferior vena cava ivc thrombosis are welldescribed complications following ivc filter placement. Inferior vena caval thrombosis radiology reference article. The initial diagnosis can be made on clinical grounds. Impact of rosuvastatin treatment on reduction of thrombus. The etiologies of ivc duplication include failure of anastomosis. Neonatal inferior vena cava and renal venous thrombosis treated by thrombectomy and nephrectomy. Swelling of the head and neck, flushing, cyanosis, respiratory distress, and neurological deficits comprise the clinical presentation. Thrombosis of the inferior vena cava ivc is an underrecognized entity with a variety of clinical presentations. Mar 17, 2020 thrombosis of the inferior vena cava ivc is an underrecognized entity with a variety of clinical presentations.
Candidates for filter placement include those with contraindications to anticoagulation or thrombolysis. The general concepts of deep venous thrombosis dvt and thrombophlebitis are discussed in detail in deep venous thrombosis. Inferior vena cava ivc filter insertion is a safe and efficacy measure for preventing pe in such cases 5. There has been an increase in the use of central venous catheters cvcs in clinical practice. Ivc thrombosis ranges in severity of clinical presentation, but can lead to significant morbidity and mortality with incidence rates depending on patient population and type of filter used. Inferior vena cava thrombosis secondary to chronic pancreatitis with pseudocyst. Central filling defect extending from the right common iliac vein into the inferior vena cava to the level of the renal veins.
Superior vena cava syndrome revealing a behcets disease. Inferior vena cava ivc thrombosis is related to the patho logical and clinical spectrum of deep venous thrombosis. An inferior vena cavagram revealed no evidence of thrombus and an appropriate vena caval diameter for filter insertion. Inferior vena cava ivc thrombosis after traumatic liver injury is an extremely rare condition, and only 12 cases have been reported in the english literature since 1911. A common femoral vein access site was used for catheterization of the venous circulation. Occlusive bilateral lower extremity deep vein thrombosis is a serious medical condition which if not treated appropriately could lead to limb loss or severe complications. Inferior vena cava ivc thrombosis is an underrecognized entity that is associated with significant morbidity and mortality. Anomalies of the inferior vena cava in patients with deep.
Ovt occurs in right ovarian vein in almost 90% of patients. Cancer, computed tomography, ovarian vein thrombosis, vena cava how to cite this. Inferior vena cava ivc thrombosis is a disease associated with high morbidity. We present a 78yearold caucasian woman with an ivc duplication who developed a deep venous thrombosis. We experienced a case of idiopathic thrombosis of the inferior vena cava ivc which was incidentally detected by ct scan. Mustafa hm, muhamad h, abdulfaraj a 2015 absent inferior vena cava with recurrent deep venous thrombosis. Nonsubtracted venography showing that chronic occlusion was of the superior vena cava. Although dvt most commonly occurs in the lower extremities 4, rarely, thrombus can also form in the inferior vena cava ivc.
Vena cava thrombosis occurred within a followup range of 9 to 818 days, with a median time to thrombosis of 30. We present a case of ivc thrombosis in an otherwise healthy and active 28yearold male soldier secondary to dehydration and venous webbing. Venogram was performed with femoral and jugular vein approach. In absence of a congenital anomaly, the most common cause of ivc thrombosis is the presence of an unretrieved ivc. Pdf duplication of the inferior vena cava and thrombosis. Inferior vena caval thrombosis statpearls ncbi bookshelf. Jun 29, 2007 thrombosis of the inferior vena cava is a lifethreatening complication in cancer patients leading to pulmonary embolism. An early diagnosis of a vena cava inferior thrombosis is essential because this is a life threatening condition if treatment is delayed. Deep vein thrombosis dvt is the development of thrombi in deep veins, usually but not only in legs. Strengths and weaknesses of a new mouse model of thrombosis induced by inferior vena cava stenosis. Congenital absence of inferior vena cava and thrombosis.
Inferior vena cava ivc thrombosis remains underrecognised as it is often not pursued as a primary diagnosis. Inferior vena cava agenesis and deep vein thrombosis. The relationship of phlebitis of the lower limbs to pulmonary embolus was established by virchow in 18461856. A 42yearold male patient was seen at consultation presenting with a pulsatile, warm and slightly. Thus for every animal with thrombosis of the vena cava, there will be many more with significant liver damage due to abscesses. We present three cases of ivc thrombosis, with each showing a different morphology. Pdf inferior vena cava ivc thrombosis remains underrecognised as it is often not pursued as a primary diagnosis. Thrombosis of the vena cava although this is generally a rare condition, it is important to recognise it as it is usually caused by a much more common condition, a liver abscess. Superior vena cava syndrome associated with massive. Treatment of superior vena cava svc syndrome and inferior. Ivc thrombosis was incidentally detected by computed tomography 15 days. Inferior vena cava filterrelated thrombusdeep vein.
Risk factors for thrombosis associated with retrievable inferior vena. Vena cava filters and inferior vena cava thrombosis. Vascular thrombosis, especially venous, is common in this condition and also constitutes a basic diagnostic criterion. The model is most suited to mice of at least 20 grams in weight. One of several treatments for these conditions, it typically is reserved for patients who cannot take blood thinning medications the most common treatment for clots. A 45yearold man was admitted to the hospital for treatment of hepatitis c and was incidentally found having an asymptomatic thrombosis of ivc. Inferior vena cava definition of inferior vena cava by the. Three different morphologies of inferior vena cava. Thrombosis of the inferior vena cava ivc is an underrecognized with a variable clinical presentation. Extensive bilateral lower extremity deep vein thrombosis in a. In later stage of the disease, trophic ulcers with or without deep vein thrombosis dvt is consistent finding. The right heart clots can induce an increased risk of mortality due the potential. Inferior vena cava ivc thrombosis is a lifethreatening condition that is rarely diagnosed in the postpartum period.
A rare case article pdf available in journal of research in medical sciences 1810. A the ivc diameter was significantly higher in group 2 than in groups 1 and 3, and significantly higher in group 3 than in group 1. The injury can occur during percutaneous cannulation of the femoral vein or during. Malignant thrombosis of the superior vena cava caused by nonsmallcell lung cancer treated with radiation and erlotinib. Superior vena cava thrombosis is a potentially lifethreatening clinical entity that mainly arises from the use of central venous catheters that may promote thrombosis and obstruction of this major vessel. A congenitally absent inferior vena cava ivc is a rare condition that is recognized to be associated with deep venous thrombosis dvt, especially in young adults. Ivc thrombus can be classified under two broad headings. Deep venous thrombosis in a child with inferior vena cava. Jul 05, 2018 if you cant take a blood thinner or if one doesnt help, your doctor may insert a small, coneshaped filter inside your inferior vena cava. It is also important to differentiate bland thrombus from tumor thrombus.
Mouse complete stasis model of inferior vena cava thrombosis. How is an inferior vena cava ivc filter used to treat. We present a rare case of an extensive venous thrombosis associated with a multisegmental anomaly of the inferior vena cava ivc, double ivcs, a hypoplastic right ivc, an aneurysm arising at the distal portion of the right ivc, and a severe stenosis between the prerenal and the hepatic segments of the ivc. Thrombosis of the inferior vena cava ivc is an underrecognized entity that is associated with significant short and longterm morbidity and. The differential diagnosis of acute and chronic thromboses determines the treatment strategy. Inferior vena cava filter thrombosis pubmed central pmc.
Bilateral breast swelling secondary to superior vena cava. The role of computed tomography ct in diagnosing acute and chronic intrafilter and ivc thromboses has not been well established. One of the most dangerous complications associated with their use is symptomatic or asymptomatic thrombosis t, sometimes associated with superior vena cava svc syndrome, resulting from impaired venous drainage. Filter placement, however, carries a 230% risk of intrafilter thrombosis, largely depending on the type of filter used 1,2,3,4. A study of 70 patients treated by ligation of the inferior vena cava and ovarian veins, surgery 30. Management of inferior vena cava thrombosis after blunt liver injury kyungyun kim, byungjun so, and dongeun park department of surgery, wonkwang university school of medicine, iksan, korea inferior vena cava ivc thrombosis after traumatic liver injury is an extremely rare condition, and only 12 cases have. We describe this case of ovt, because, even though rare, it is a diagnosis to consider. It may lead to fatal complications such as sepsis, inferior vena cava thrombosis ivc, pulmonary emboli, and death. Idiopathic thrombosis of the inferior vena cava and bilateral.
Thrombosis of the inferior vena cava ivc is an underrecognized entity that is associated with significant short and longterm morbidity and mortality. The inferior vena cava or ivc is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. Duplication of the inferior vena cava and thrombosis. Therapy of catheterdirected thrombolysis for inferior vena cava thrombosis after filter implantation. Its affection of the superior vena cava is rather rare with only a few cases described in the literature. Obstruction to the superior vena cava, though easily recognised, is a pathological condition of some rarity. Pulmonary embolism is a fatal consequence of ivc thrombosis, particularly when it is acute and floating. The aetiology of ivc thrombosis can be divided into congenital versus acquired, with. The prepic2 study, which evaluated retrievable ivc filters, demonstrated a significantly lower rate of filter thrombosis 3193 patients, 1. We report the case of a 61yearold female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Malignant thrombosis of the superior vena cava caused by.
Inferior vena cava definition of inferior vena cava by. It can easily be confused with acute appendicitis, pelvic infection, ovarian torsion, tuboovarian abscess, and pyelonephritis. Sorin pop1, iulianu opincaru2 1 1st internal medicine department, 2department of anatomy and embriology, university of medicine and pharmacy iuliu hatieganu cluj napoca, romania. Vena cava filter deep vein thrombosis uab medicine. However, the implications and complexity of ivc thrombosis ivct merit specific attention.
Clinical assistant, brompton ilospital for consumption and diseases of the chest. Iliocaval thrombosis, or thrombosis of the inferior vena cava and iliac veins, is associated with significant morbidity in the form of limbthreatening compromise from phlegmasia cerulean dolens. Its walls are rigid and it has valves so the blood does not flow down via gravity. Kidney and inferior vena cava abnormalities with leg thrombosis is a newly described entity in the literature termed kilt kidney and inferior vena cava ivc abnormalities with leg thrombosis syndrome. Presentation and management of inferior vena cava thrombosis. Inferior vena cava duplication and deep venous thrombosis. To prospectively evaluate the efficacy of mr imaging in inferior vena cava ivc thrombosis. Inferior vena cava thrombosis abstract thrombosis of the inferior vena cava ivc is an underrecognized entity that is associated with signi.
Inferior vena caval thrombosis clinical presentation. Known underlying prostatic malignancy likely to have caused the prothrombotic state of the patient. There are few reported cases with ivc duplication and thrombosis of lower extremities. Congenital absence of the inferior vena cava introduction variations and anomalies of the inferior vena cava ivc, while rare, are well documented in literature. The first page of the pdf of this article appears above. Apr 11, 2018 a permanently indwelling filter in the inferior vena cava ivc may induce caval thrombosis, which could develop and evolve from an acute to a chronic phase. However, the serious problem of preventing emboli from reaching the lungs has not been satisfactorily solved to date. We report a case of a 26yearold man who presented with ivc thrombosis after blunt liver injury. Mar 17, 2020 compression of the inferior vena cava by right renal cysts. Pe, a complication of dvt, occurs when a thrombus gets detached from its. Seventeen patients with suspected ivc thrombosis underwent 30 mr examinations. Inferior vena cava ivc thrombosis is related to the pathological and clinical spectrum of deep venous thrombosis dvt. Percutaneous treatment of superior vena cava syndrome caused by chronic thrombosis 77 figure 1. To diagnose a deep venous thrombosis dvt a clinical prediction score the wells scoring system has been proposed table table1 1.
Postpartum ovarian vein and inferior vena cava thrombosis. Absent inferior vena cava with recurrent deep venous. The bright parallel echoes represent parts of a filter in the ivc that was placed secondary to repeated lower limb thrombosis in order to prevent pulmonary emboli. However, the true incidence of ivc thrombosis may be underestimated due to the lack of standardized methods of its detection and reporting, as. Vena cava filters have been increasingly used in patients with lowerextremity deep venous thrombosis dvt to avoid pulmonary embolism. This case demonstrates a gigantic ivc thrombosis extending from the right atrium to below the renal veins, over a length of 15cm. In absence of a congenital anomaly, the most common cause of ivc thrombosis is the presence of an unretrieved ivc filter.
Catheterinduced thrombosis of the superior vena cava. In the puerperal setting it is presumably the result of extension of clot from either the iliac or ovarian veins. Management of inferior vena cava thrombosis after blunt liver. Trauma is also a cause of inferior vena cava thrombosis. Inferior vena caval thrombosis differential diagnoses. Atrophic inferior vena cava is a marker of chronicity of. The mouse complete stasis model of inferior vena cava thrombosis can be performed on multiple strains of mice of varying ages. Management of inferior vena cava thrombosis after blunt. Thrombus in the inferior vena cava in a patient with lupus. Inferior vena caval ivc thrombosis is an essential diagnosis while evaluating any neoplastic lesion, or portal hypertension. Two patients with superior vena cava syndrome svcs associated with massive thrombosis were treated by means of local thrombolytic therapy and placement of modified gianturco expandable wire stents. Although anticoagulation remains the standard of care, endovascular.
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