Hepatic vena cava syndrome: a case report and literature review.

BACKGROUND

Hepatic vena cava syndrome (HVCS) is an uncommon condition, with no prior reports from the Gulf area. In regions with limited resources, where this disease is found, there is a lack of data due to underdiagnosis. HVCS results from recurrent bacterial thrombophlebitis of the hepatic portion of the inferior vena cava (IVC), causing intimal thickening and obstruction, eventually leading to complications like liver cirrhosis and hepatocellular carcinoma.

CASE PRESENTATION

A 32-year-old Afghan refugee lady, presented with progressive abdominal distention. Initial investigations showed anemia, splenomegaly, and massive ascites. Further investigations revealed cirrhotic liver, varices, and a stenotic segment of the IVC. She was diagnosed with HVCS, underwent IVC stenting, and commenced on clopidogrel and dabigatran. Conclusion Often misdiagnosed, HVCS requires a high index of suspicion and should be considered in patients with liver cirrhosis with low socioeconomic backgrounds. Early diagnosis can prevent liver cirrhosis and hepatocellular carcinoma.