Pichon M, Hij A, Wifaq B, Abderrahmane M, El Jarrari M, Menn A-M
Service de médecine polyvalente, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prudhon, 95100 Argenteuil, France.
Service de médecine interne et pathologie vasculaire, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
J Med Vasc. 2019 Feb;44(1):79-85. doi: 10.1016/j.jdmv.2018.11.005. Epub 2018 Dec 19.
Congenital agenesis of the inferior vena cava, although rare, is found preferentially in young patients with proximal deep venous thrombosis. Exact diagnosis can be made thanks to enhanced computed tomography scan and/or magnetic resonance imaging, while Doppler ultrasonography is insufficient to establish an inferior vena cava malformation. A consensus has not yet been established for the treatment but lifelong anticoagulation with elastic stocking support to prevent post-thrombotic syndrome is commonly considered in most cases. We report a case of an unprovoked deep venous thrombosis caused by a congenital agenesis of the inferior vena cava localized to the infrarenal segment, in a 24-year-old man. An anticoagulation with low molecular weight heparin was started and prolonged oral anticoagulation was prescribed. In the absence of the usual thrombotic risk factors, the presence of an inferior vena cava anomaly should be considered.
先天性下腔静脉缺如虽然罕见，但多见于患有近端深静脉血栓形成的年轻患者。借助增强计算机断层扫描和/或磁共振成像可做出准确诊断，而多普勒超声检查不足以确诊下腔静脉畸形。对于治疗尚未达成共识，但在大多数情况下，通常考虑采用终身抗凝并辅以弹力袜支撑以预防血栓形成后综合征。我们报告一例24岁男性患者，其由肾下段先天性下腔静脉缺如引起不明原因的深静脉血栓形成。开始使用低分子量肝素进行抗凝，并开具了长期口服抗凝药。在没有常见血栓形成危险因素的情况下，应考虑存在下腔静脉异常。
