Harris R W, Andros G, Dulawa L B, Oblath R W, Horowitz R
Vascular Laboratory, Saint Joseph Medical Center, Burbank, CA 91505.
J Vasc Surg. 1987 Dec;6(6):594-9.
Nonthrombotic iliofemoral venous obstruction, masquerading as deep vein thrombosis, was diagnosed in four patients. In each instance the patient was hospitalized and intravenous heparin therapy was started. Phlebography demonstrated venous outflow obstruction without thrombosis; subsequent CT scanning revealed an obstructing lesion in each case. At surgical exploration, (1) endoaneurysmorrhaphy of a hypogastric artery aneurysm decompressed an obstructed right iliac vein; (2) a primary iliac vein leiomyosarcoma was extirpated; (3) a synovial cyst arising from the right hip joint, which obstructed the femoral vein, was excised; and, (4) a postherniorrhaphy inflammatory mass obstructing the left iliofemoral vein junction was confirmed with biopsy results. Improved diagnostic accuracy with its attendant specific therapy is achieved in suspected cases of iliofemoral vein thrombosis if, in addition to noninvasive venous studies or phlebography, CT scanning of the abdomen and pelvis is performed.
四名患者被诊断为伪装成深静脉血栓形成的非血栓性髂股静脉阻塞。在每例患者中，患者均住院并开始静脉注射肝素治疗。静脉造影显示静脉流出道阻塞但无血栓形成；随后的CT扫描显示每例均有阻塞性病变。手术探查发现：（1）一例髂内动脉瘤的动脉瘤内缝扎术解除了右髂静脉阻塞；（2）切除了一例原发性髂静脉平滑肌肉瘤；（3）切除了一例起源于右髋关节、阻塞股静脉的滑膜囊肿；（4）经活检证实一例疝修补术后炎性肿块阻塞左髂股静脉交界处。对于疑似髂股静脉血栓形成的病例，如果除了进行非侵入性静脉检查或静脉造影外，还对腹部和骨盆进行CT扫描，可提高诊断准确性并随之采取针对性治疗。
