Nonoperative management of traumatic suprahepatic inferior vena cava pseudoaneurysms

Abstract

Inferior vena cava (IVC) pseudoaneurysms are rare clinical entities with an uncertain natural history due to limited follow-up information. This case report describes a 30-year-old woman with two IVC pseudoaneurysms and their associated anatomy. It also details our treatment plan, with follow-up through radiographic resolution of the pseudoaneurysms. To our knowledge, this is the first case report to document a patient with two pseudoaneurysms of the IVC and full resolution treated by nonoperative management.

Vascular Trauma

“…The blunt injury of IVC is a very rare condition, with a prevalence of 1% of all blunt abdominal traumas resulting in dissection, pseudoaneurysm formation, or IVC thrombosis. In the literature there are single reports in the management of IVS blunt injuries usually catheter-directed techniques [16,34,35].…”

Plain and Contrast Enhanced CT Imaging Findings of a Rare Case of IVC Pseudoaneurysm

“…Traumatic inferior vena cava (IVC) lesions represent 30% to 40% of trauma related abdominal vascular injuries [1]. IVC aneurysms are rare clinical entity, are always acquired [2]. Most of them develop secondary to traumatic vascular injury [2] [3] [4] [5].…”

“…IVC aneurysms are rare clinical entity, are always acquired [2]. Most of them develop secondary to traumatic vascular injury [2] [3] [4] [5]. By definition pseudoaneurysm is a contained pulsatile hematoma near vessel wall puncture or tear that communicates with vessel [6].…”

“…By definition pseudoaneurysm is a contained pulsatile hematoma near vessel wall puncture or tear that communicates with vessel [6]. Account for approximately 25% of abdominal vascular injuries [2]. The spectrum of blunt caval injuries range from intimal flaps to extensive destruction [7].…”

“…The spectrum of blunt caval injuries range from intimal flaps to extensive destruction [7]. Disruption of one or more layers of the wall leads to slow extravasation of blood, allowing the areolar tissue in the vicinity to form a sac consistent with pseudoaneurysm and/weakness in the vessel wall and gradually results in dilatation and aneurysm formation [2] [4]. Though aneurysms and pseudoaneurysms of the IVC are anatomically different are discussed similarly because they behave in the same way [2].…”