Sawafta Khaled, Yousef Fadi, Hijleh Hani Abu, Abdat Wasef, Samara Yousef, Al-Kharraz Tasbeeh
Department of Medicine, An Najah National University, Nablus, Palestine.
Department of Radiology, Rafidia Surgical Hospital, Nablus, Palestine.
Radiol Case Rep. 2025 Jan 8;20(3):1740-1744. doi: 10.1016/j.radcr.2024.12.038. eCollection 2025 Mar.
May-Thurner syndrome (MTS), iliac vein compression syndrome, also called Cockett syndrome, is a vascular disease caused by the compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the lumbar vertebrae. This anatomical defect can lead to venous stasis especially in the left lower limb, and this increases the risk of deep venous thrombosis (DVT). Because routine screening is not standard practice, MTS frequently remains asymptomatic, and its prevalence is probably underestimated. Our case report presents 33 year old women with no thrombotic condition history who complained from a left leg swelling, pain, and stiffness over 5 days. Computed tomography angiography (CTA) confirmed a diagnosis of MTS, and Doppler ultrasonography confirmed extensive DVT in the left lower limb. After receiving conservative treatment with enoxaparin, the patient switched to apixaban therapy. The significance of identifying MTS as a possible cause of unilateral left-sided DVT is highlighted by this case, especially in young, otherwise healthy women. Recurrent DVT and chronic venous insufficiency are among the complications that can be prevented by early detection with imaging and anticoagulation treatment. Patients with atypical DVT presentations may benefit from earlier diagnosis and treatment made possible by greater knowledge of MTS.
梅-图二氏综合征(MTS),即髂静脉受压综合征,也称为科克特综合征,是一种血管疾病,由右髂总动脉(RCIA)压迫左髂总静脉(LCIV)使其紧贴腰椎椎体所致。这种解剖学缺陷可导致静脉淤滞,尤其是在左下肢,进而增加深静脉血栓形成(DVT)的风险。由于常规筛查并非标准做法,MTS常常没有症状,其患病率可能被低估。我们的病例报告介绍了一名33岁无血栓形成病史的女性,她诉说左腿肿胀、疼痛和僵硬已持续5天。计算机断层扫描血管造影(CTA)确诊为MTS,多普勒超声检查证实左下肢存在广泛的DVT。在用依诺肝素进行保守治疗后,患者改用阿哌沙班治疗。该病例凸显了将MTS确定为单侧左侧DVT可能病因的重要性,尤其是在年轻且无其他健康问题的女性中。复发性DVT和慢性静脉功能不全是可通过影像学早期检测和抗凝治疗预防的并发症。对于非典型DVT表现的患者,更深入了解MTS有助于实现更早的诊断和治疗,从而使其受益。