Ji Lianfu, Yang Fan, Chen Xuan, Chen Jinlong, Cheng Xueying, Yin Jie, Qin Yuming, Yang Shiwei
Department of Cardiology, Children's Hospital of Nanjing Medical University, Nanjing, China.
Front Pediatr. 2021 Jul 15;9:694782. doi: 10.3389/fped.2021.694782. eCollection 2021.
Iliac vein compression syndrome (IVCS) or May-Thurner syndrome occurs predominantly in young to middle-aged women. Here we reported a case of IVCS in a 5-year-old boy. The child was admitted to our vasculocardiology department with left lower extremity that had been swollen for 1 month. Blood tests revealed coagulation routine and platelets in the normal ranges. Computer tomography angiography (CTA) and magnetic resonance imaging (MRI) showed the left common iliac vein had become narrow before it entered the right common iliac vein. To further clarify, we performed angiography, which clearly showed the stenosis and the blood return of the left common iliac vein. So IVCS was diagnosed. What is more, we found the aorta descended to the right of the spine, and this may be the reason for the apparent compression of the left common iliac vein. Given the young age and mild symptoms of the child, the treatment was conservative mainly including elevation of the affected limb, wearing medical elastic socks, and short-term oral aspirin for anticoagulation. Meanwhile, the boy is being followed up closely. If the swelling of the left lower extremity significantly increases, stent placement may need to be considered in the future.
髂静脉压迫综合征（IVCS）或梅-图二氏综合征主要发生于中青年女性。在此，我们报告一例5岁男孩的IVCS病例。该患儿因左下肢肿胀1个月入住我院血管心脏病科。血液检查显示凝血常规和血小板在正常范围内。计算机断层血管造影（CTA）和磁共振成像（MRI）显示左髂总静脉在汇入右髂总静脉之前变窄。为进一步明确，我们进行了血管造影，清晰显示了左髂总静脉的狭窄及血液回流情况。于是诊断为IVCS。此外，我们发现主动脉降于脊柱右侧，这可能是左髂总静脉明显受压的原因。鉴于患儿年龄小且症状较轻，治疗以保守为主，主要包括抬高患肢、穿戴医用弹力袜以及短期口服阿司匹林进行抗凝。同时，该男孩正在接受密切随访。如果左下肢肿胀明显加重，未来可能需要考虑放置支架。
