先天性下腔静脉缺如伴溃疡和深静脉血栓形成
Congenital Inferior Vena Cava Agenesis with Ulceration and Deep Vein Thrombosis.
作者信息
Menning Melanie, Yousef Mira
机构信息
Department of Family Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA.
出版信息
Eur J Case Rep Intern Med. 2021 Mar 18;8(3):002312. doi: 10.12890/2021_002312. eCollection 2021.
OBJECTIVES
This is one of the few case reports of congenital inferior vena cava atresia (IVCA) with extensive bilateral lower extremity ulcers.
BACKGROUND
IVCA is a congenital anomaly characterized by poor venous return in the lower extremities with increased risk of deep vein thrombi (DVTs) and, rarely, non-healing ulcers.
RESULTS
A 45-year-old woman with history significant for DVTs presented with extensive bilateral lower extremity ulcers, and a CT scan revealed congenital IVCA. Oedema management, DVT prevention, routine wound care and skin grafts resolved the ulcers.
CONCLUSION
Congenital venous abnormalities should be included in the differential diagnosis of multiple unprovoked DVTs and non-healing ulcers.
LEARNING POINTS
There are very few reports in the English literature describing inferior vena cava atresia with extensive bilateral lower extremity ulcers.We present our findings as well as new insights into the congenital causes of bilateral lower extremity ulcers and deep vein thrombi (DVTs).Especially for young adults with a history of multiple DVTs and non-healing ulcers, venous abnormalities should be included in the differential diagnosis and advanced imaging should be utilized.
目的
这是少数关于先天性下腔静脉闭锁（IVCA）伴双侧下肢广泛溃疡的病例报告之一。
背景
IVCA是一种先天性异常，其特征为下肢静脉回流不畅，深静脉血栓形成（DVT）风险增加，且很少出现不愈合溃疡。
结果
一名有DVT病史的45岁女性出现双侧下肢广泛溃疡，CT扫描显示为先天性IVCA。通过水肿管理、DVT预防、常规伤口护理和皮肤移植，溃疡得以愈合。
结论
先天性静脉异常应纳入多发性不明原因DVT和不愈合溃疡的鉴别诊断。
学习要点
英文文献中很少有描述下腔静脉闭锁伴双侧下肢广泛溃疡的报告。我们展示了我们的研究结果以及对双侧下肢溃疡和深静脉血栓形成（DVT）先天性病因的新见解。特别是对于有多次DVT病史和不愈合溃疡的年轻人，应将静脉异常纳入鉴别诊断，并采用高级影像学检查。
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