Ahmed Ahmed Ka, Finocchi Vanina, Al-Agib Salah
Department of Radiology, Nobles Hospital, Douglas, Isle of Man.
BJR Case Rep. 2018 Apr 16;4(3):20180018. doi: 10.1259/bjrcr.20180018. eCollection 2018 Mar.
Inferior vena cava (IVC) anomalies have been reported to have an association with deep venous thrombosis of the lower limbs. It is, therefore, necessary to study the IVC in recurrent cases of unprovoked deep venous thrombosis (DVT) and/or pulmonary embolism (PE), where all other causes have been excluded. We report a case of a 65-year-old male, who had recurrent episodes of DVT in the past 5 years; some of which associated with PE of unknown cause. CT thorax abdomen and pelvis did not find an obvious cause for the DVT and/or PE, however, it did highlight a diffuse calcification of the IVC. Only a few cases of calcification of the IVC have been reported in literature, and a number of them have been associated with clot formation and PE. We speculate that, as in other anomalies of the IVC, calcification of the IVC might slow the blood flow, and thus predispose to DVT and/or PE. Our opinion is that in all cases of unexplained DVT and/or PE, a careful examination of the IVC should be performed. Furthermore, when this condition is present, other risk factors for hypercoagulability should be avoided and anticoagulant therapy should be considered.
据报道，下腔静脉（IVC）异常与下肢深静脉血栓形成有关。因此，有必要在所有其他病因已被排除的不明原因的复发性深静脉血栓形成（DVT）和/或肺栓塞（PE）病例中研究下腔静脉。我们报告一例65岁男性病例，该患者在过去5年中反复发生DVT；其中一些与不明原因的PE相关。胸部、腹部和骨盆CT未发现DVT和/或PE的明显病因，然而，它确实突出显示了下腔静脉的弥漫性钙化。文献中仅报道了少数几例下腔静脉钙化病例，其中一些与血栓形成和PE有关。我们推测，与下腔静脉的其他异常情况一样，下腔静脉钙化可能会减缓血流，从而易患DVT和/或PE。我们认为，在所有不明原因的DVT和/或PE病例中，都应仔细检查下腔静脉。此外，当出现这种情况时，应避免其他高凝风险因素，并应考虑抗凝治疗。
