Mukai Yuichi, Nozawa Shuhei, Suzuki Toshiro
Department of Respiratory Medicine, National Hospital Organization Matsumoto Medical Center, Matsumoto, Nagano, Japan.
BMJ Case Rep. 2018 Apr 7;2018:bcr-2017-223610. doi: 10.1136/bcr-2017-223610.
Venous compression syndromes are caused by extrinsic venous compression of anatomical structures, such as the adjacent arteries and bones. Chronic venous compression and pulsative vibratory arterial pressure accelerate the development of deep vein thrombosis. Herein, we report the first case of double venous compressions due to a duplicated inferior vena cava-induced right-sided common iliac vein thrombosis. The thrombus was induced by left-sided inferior vena cava entrapment and right-sided common iliac vein compression, resembling nutcracker syndrome and May-Thurner syndrome, respectively. Bypass flow of the right inferior vena cava rendered the right lower extremity asymptomatic. Once daily anticoagulation edoxaban was effective. Congenital venous anomalies and bypass formations should be considered when a common iliac vein thrombus without symptoms in the lower extremities is observed, and a lifelong periodical follow-up is mandatory, even after remission.
静脉压迫综合征是由解剖结构（如相邻动脉和骨骼）的外部静脉压迫引起的。慢性静脉压迫和搏动性振动动脉压会加速深静脉血栓形成的发展。在此，我们报告首例因下腔静脉重复畸形导致右侧髂总静脉血栓形成而引起的双重静脉压迫病例。血栓分别由左侧下腔静脉受压和右侧髂总静脉受压所致，类似于胡桃夹综合征和梅-特综合征。右下腔静脉的旁路血流使右下肢无症状。每日一次的抗凝药物依度沙班治疗有效。当观察到下肢无症状的髂总静脉血栓时，应考虑先天性静脉异常和旁路形成，并且即使在病情缓解后，也必须进行终身定期随访。
