Sabzi Feridoun, Karim Hosein, Haghi Marjan
Department of Cardiovascular Surgery, Imam Ali Heart Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Email:
J Inj Violence Res. 2016 Jul;8(2):111-3. doi: 10.5249/jivr.v8i2.769. Epub 2016 Jan 31.
We present a case of nephrotic syndrome associated with right atrial and supra hepatic vein part of inferior vena caval thrombosis. This patient presented with dyspena, lower extremity edema and back pain after a vehicle accident and blunt trauma to the abdomen. Trauma should be considered not only as a thrombophilic pre-disposition, but also as a predisposing factor to IVC endothelium injury and thrombosis formation. Echocardiography revealed supra hepatic vein IVC thrombosis floating to the right atrium. A C-T scan with contrast also showed pulmonary artery emboli to the left upper lobe. With open heart surgery, the right atrial and IVC clot were extracted and the main left and right pulmonary arteries were evaluated for possible clot lodging. The patient had an uneventful postoperative recovery and thrombosis has not reoccurred with periodical follow-up examinations.
我们报告一例肾病综合征合并右心房及下腔静脉肝上段血栓形成的病例。该患者在车祸及腹部钝性创伤后出现呼吸困难、下肢水肿和背痛。创伤不仅应被视为血栓形成的易患因素，还应被视为下腔静脉内皮损伤和血栓形成的诱发因素。超声心动图显示肝上段下腔静脉血栓漂浮至右心房。增强CT扫描还显示左上叶肺动脉栓塞。通过心脏直视手术，取出右心房和下腔静脉内的血栓，并评估左右主肺动脉是否有血栓栓塞。患者术后恢复顺利，定期随访检查未再发生血栓形成。
