Prado Victor E, Rey-Mendoza Juan Pablo, Wakefield Connor J, Aqeel Sheeba Ba, Kumssa Admasu
Division of Internal Medicine, Department of Medicine, University of Cincinnati, Cincinnati, OH, USA.
Division of Pulmonary and Critical Care, Department of Medicine, University of Wisconsin, Madison, WI, USA.
Oxf Med Case Reports. 2021 Jan 12;2021(1):omaa104. doi: 10.1093/omcr/omaa104. eCollection 2021 Jan.
Inferior vena cava agenesis is a rare congenital vascular defect often diagnosed as an incidental finding in asymptomatic patients. When symptoms arise, it can present with chronic venous stasis or unprovoked deep vein thrombosis (DVT). A 42-year-old man with history of unprovoked right lower extremity (RLE) DVTs was admitted for swelling, pain and erythema to the RLE, concerning for new DVT. Venous Doppler ultrasound showed a chronic DVT of the right proximal femoral vein in addition to an acute DVT of the distal femoral vein. Extensive thrombophilia workup was negative and additional imaging with abdominal computed tomography scan revealed the absence of the infrarenal inferior vena cava. Patient was treated with oral anticoagulation and compression stockings and discharged with clinical improvement. At 3-month follow-up, patient was completely asymptomatic. Recurrent unprovoked DVTs in young patients require exhaustive work up including imaging studies to rule out vascular anomalies.
下腔静脉发育不全是一种罕见的先天性血管缺陷，常在无症状患者中作为偶然发现而被诊断出来。当出现症状时，可能表现为慢性静脉淤血或不明原因的深静脉血栓形成（DVT）。一名有不明原因右下肢DVT病史的42岁男性因右下肢肿胀、疼痛和红斑入院，怀疑有新的DVT。静脉多普勒超声显示右股浅静脉近端为慢性DVT，同时股静脉远端为急性DVT。广泛的血栓形成倾向检查结果为阴性，腹部计算机断层扫描的进一步成像显示肾下下腔静脉缺如。患者接受了口服抗凝治疗和弹力袜治疗，出院时临床症状有所改善。在3个月的随访中，患者完全无症状。年轻患者反复出现不明原因的DVT需要进行全面检查，包括影像学检查以排除血管异常。
