Dougherty M J, Calligaro K D, DeLaurentis D A
Section of Vascular Surgery, Pennsylvania Hospital, Thomas Jefferson University, Philadelphia, USA.
J Vasc Surg. 1996 Jan;23(1):141-6. doi: 10.1016/s0741-5214(05)80044-8.
Absence of the inferior vena cava (IVC) is an uncommon congenital abnormality. Symptoms of lower extremity venous insufficiency resulting from this anatomic abnormality have been reported only once in the English literature, and no experience with surgical treatment of this condition has been published. We report the case of an otherwise healthy 41-year-old man with an 18-month history of severe venous insufficiency involving the right leg manifested by extensive ulceration that did not respond to aggressive conservative treatment. Duplex findings were not suggestive of venous obstruction or reflux, but venography documented no filling of the common iliac vein or inferior vena cava, and outflow was via collaterals to the azygous and hemiazygous systems. Computed tomography demonstrated complete absence of the inferior vena cava with azygous continuation. A prosthetic bypass from the external iliac to the intrathoracic azygous vein was performed with complete symptomatic relief after a 30-month follow-up period. Venous bypass surgery may play a role in treatment of this rare cause of venous insufficiency.
下腔静脉缺如是一种罕见的先天性异常。英文文献中仅报道过1例因这种解剖异常导致下肢静脉功能不全的病例，且尚无关于该病症手术治疗的经验发表。我们报告1例41岁的健康男性病例，其右下肢严重静脉功能不全已有18个月病史，表现为广泛溃疡，积极保守治疗无效。双功超声检查结果未提示静脉阻塞或反流，但静脉造影显示髂总静脉或下腔静脉无造影剂充盈，血流通过侧支循环流入奇静脉和半奇静脉系统。计算机断层扫描显示下腔静脉完全缺如，由奇静脉延续替代。行髂外静脉至胸内奇静脉的人工血管旁路移植术，30个月随访期后症状完全缓解。静脉旁路手术可能在治疗这种罕见的静脉功能不全病因中发挥作用。
