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年轻患者隐匿性下腔静脉的发现:病例报告与临床见解

Unveiling absent inferor vena cava in young patients: Case reports and clinical insights.

作者信息

Tadayon Niki, Najari Dorsa, Refaei Meisam, Sheikhzadeh Mohsen, Babaei Masoud, Mirhosseini Mohammad Moein

机构信息

Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Division of Vascular and Endovascular Surgery, Department of Surgery, Shohada-Tajrish Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110258. doi: 10.1016/j.ijscr.2024.110258. Epub 2024 Sep 7.

Abstract

INTRODUCTION

Inferior vena cava agenesis (IVCA), a rare congenital anomaly, contributes to approximately 5 % of deep venous thrombosis (DVT) cases lacking other risk factors. It can lead to chronic venous insufficiency and DVT when collateral circulation is insufficient, presenting diagnostic challenges due to its rarity.

CASE PRESENTATION

We present two cases of Absent IVC (AIVC) in young males. Case 1: a 22-year-old developed bilateral lower limb DVT post-appendectomy. Imaging revealed AIVC with azygos continuation. Treatment included Heparin and Rivaroxaban, achieving symptom resolution. Case 2: a 41-year-old with recurrent DVT and chronic venous insufficiency was diagnosed with AIVC via venography. Managed with warfarin and compression therapy, his symptoms stabilized.

CLINICAL DISCUSSION

These cases underscore the importance of recognizing AIVC in young patients presenting with unexplained DVT. Diagnosis often requires advanced imaging techniques like CT venography. Management typically involves long-term anticoagulation and compression therapy to mitigate the risk of recurrence and chronic venous complications.

CONCLUSION

Early identification of AIVC in young adults presenting with recurrent DVT is essential for appropriate management and prevention of long-term complications.

摘要

引言

下腔静脉发育不全(IVCA)是一种罕见的先天性异常,在缺乏其他危险因素的深静脉血栓形成(DVT)病例中约占5%。当侧支循环不足时,它可导致慢性静脉功能不全和DVT,因其罕见而带来诊断挑战。

病例报告

我们报告两例年轻男性下腔静脉缺如(AIVC)的病例。病例1:一名22岁男性在阑尾切除术后发生双侧下肢DVT。影像学检查显示为奇静脉延续的AIVC。治疗包括使用肝素和利伐沙班,症状得到缓解。病例2:一名41岁男性患有复发性DVT和慢性静脉功能不全,通过静脉造影诊断为AIVC。采用华法林和压迫疗法进行治疗,其症状得以稳定。

临床讨论

这些病例强调了在出现不明原因DVT的年轻患者中识别AIVC的重要性。诊断通常需要CT静脉造影等先进的影像学技术。治疗通常包括长期抗凝和压迫疗法,以降低复发风险和慢性静脉并发症。

结论

对于出现复发性DVT的年轻成年人,早期识别AIVC对于适当的管理和预防长期并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1fae/11417193/c442f6f45eee/gr1.jpg

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