Kim Sang, Kunkel Scott, Browske Kristin
U.S. Navy Aviation Medicine, Marine Aircraft Group 14, PO Box 8051, Cherry Point, NC 28533.
Naval Hospital Clinic Cherry Point, 4389 Beaufort Road, Havelock, NC 28532.
Mil Med. 2018 Jan 1;183(1-2):e172-e174. doi: 10.1093/milmed/usx041.
Anomalies of the inferior vena cava (AIVC) are rare but well-recognized anatomic abnormalities that can lead to clinically significant deep vein thrombosis (DVT) in a subset of otherwise healthy patients. This report illustrates an uncommon congenital anomaly that military clinicians should consider when evaluating unprovoked DVT in young patients.
Single case report and literature review.
We describe a case of a 24-yr-old United States Marine who presented with abdominal pain for 2 wk. After conservative therapy failed, a contrast-enhanced abdominal computed tomography (CT) scan was performed. The CT scan revealed an absent inferior vena cava with evidence of right venous thrombophlebitis. We include four contrast-enhanced helical CT scans that illustrate this phenomenon.
Due to the lack of available studies and data, we do not know the relative risk of DVT in patients with AIVC. However, the literature review suggests that there is a pro-thrombogenic effect of this congenital anomaly. Clinicians should include AIVC in their differential when treating young, otherwise healthy patients with unprovoked DVT. This population is much more likely to have an AIVC than the general population. In addition to thrombophilia markers, a contrast-enhanced CT scan should be considered as part of the initial workup.
下腔静脉异常（AIVC）较为罕见，但却是公认的解剖学异常，在部分原本健康的患者中可导致具有临床意义的深静脉血栓形成（DVT）。本报告阐述了一种罕见的先天性异常，军事临床医生在评估年轻患者的不明原因DVT时应予以考虑。
单病例报告及文献综述。
我们描述了一名24岁美国海军陆战队队员的病例，该患者出现腹痛2周。保守治疗失败后，进行了腹部增强计算机断层扫描（CT）。CT扫描显示下腔静脉缺如，并伴有右静脉血栓性静脉炎的迹象。我们纳入了四张增强螺旋CT扫描图像以说明这一现象。
由于缺乏可用的研究和数据，我们尚不清楚AIVC患者发生DVT的相对风险。然而，文献综述表明这种先天性异常具有促血栓形成作用。临床医生在治疗不明原因DVT的年轻且原本健康的患者时，应将AIVC纳入鉴别诊断。该人群发生AIVC的可能性远高于普通人群。除了血栓形成倾向标志物外，增强CT扫描应被视为初始检查的一部分。
