Sitwala Puja S, Ladia Vatsal M, Brahmbhatt Parag B, Jain Vinay, Bajaj Kailash
Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
Department of Radiology, Veterans Affairs Medical Center, Johnson City, Tennessee, USA.
N Am J Med Sci. 2014 Nov;6(11):601-3. doi: 10.4103/1947-2714.145486.
Inferior vena cava (IVC) anomalies have a 0.5% incidence rate and could be associated with other congenital abnormalities. In later stage of the disease, trophic ulcers with or without deep vein thrombosis (DVT) is consistent finding.
A 29-year-old male patient presented with recurrent lower extremity ulcers. Further workup revealed an absent infrahepatic inferior vena cava, prominently dilated azygos and hemiazygos veins with enlarged retroperitoneal collaterals without DVT.
IVC anomaly should be suspected in a young patient presenting with unexplained venous thrombosis and recurrent ulcers of a lower extremity. IVC anomaly would inherently lead to blood flow stasis and endothelial injury. Thus per Virchow's triad, other risk factors for hypercoagulability such as physical inactivity, smoking tobacco, oral contraceptive pills should be avoided and when hereditary thrombophilias or other irreversible risk factors are present, lifelong anticoagulation should be considered.
下腔静脉（IVC）异常的发生率为0.5%，可能与其他先天性异常有关。在疾病后期，出现有或无深静脉血栓形成（DVT）的营养性溃疡是一致的表现。
一名29岁男性患者出现复发性下肢溃疡。进一步检查发现肝下下腔静脉缺如，奇静脉和半奇静脉明显扩张，腹膜后侧支循环增粗，无DVT。
对于出现不明原因静脉血栓形成和复发性下肢溃疡的年轻患者，应怀疑存在IVC异常。IVC异常会固有地导致血流淤滞和内皮损伤。因此，根据维勒布兰德氏三联征，应避免其他高凝风险因素，如缺乏运动、吸烟、口服避孕药，当存在遗传性血栓形成倾向或其他不可逆转的风险因素时，应考虑终身抗凝。
