Retroperitoneal Hematoma Caused by a Ruptured Pelvic Varix in a Patient with Iliac Vein Compression Syndrome

Dheer, Sachin; Joseph, Abraham; Drooz, Alain

doi:10.1097/01.rvi.0000058411.01661.2b

Cited by 23 publications

(16 citation statements)

References 17 publications

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“…5 One patient was treated with conservative therapy, 19 and several received endovascular interventions. 8,12 One patient received combined surgical and endovascular stent treatment. 3 Three (33.3%) of our nine patients were managed conservatively, and the others were treated by surgical (n ϭ 5) or combined methods (n ϭ 1).…”

Section: Discussionmentioning

confidence: 99%

“…20 Given left-side preponderance and coincident presence, May-Thurner syndrome may be a factor in this entity. 8 Venous hypertension produced by proximal obstruction can trigger inflammatory cascades and decrease contractility. 21,22 The mechanism of iliac vein rupture may be a sudden rise in venous pressure in weakened vein due to loss of estrogen, complications of pregnancy, and May-Thurner syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…To date, 35 patients with spontaneous iliac vein rupture have been reported, [2][3][4] of which almost 79% had concomitant deep venous thrombosis (DVT) or thrombophlebitis 2 and approximately 28.6% had May-Thurner syndrome. 3,[5][6][7][8][9][10][11][12][13] In this study, we investigated SRH associated with iliac vein rupture. Owing to the inability to institute anticoagulation and initial uncertainty in diagnosis, management of these patients presents significant challenges.…”

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confidence: 99%

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Spontaneous retroperitoneal hematoma associated with iliac vein rupture

Jiang

Ding

Zhang

et al. 2010

Journal of Vascular Surgery

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SRH with concomitant DVT, especially in women aged >45, should be considered in patients with sudden lower abdominal or lumbar pain, leg swelling, anemia, and shock. Spontaneous iliac vein rupture and the presence of May-Thurner syndrome should be considered in these patients. Surgical interventions were associated with high mortality and morbidity. In our experience, conservative therapy was safer than open surgical procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Spontaneous retroperitoneal hematoma associated with iliac vein rupture

Jiang

Ding

Zhang

et al. 2010

Journal of Vascular Surgery

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“…Furthermore continued trauma leads to local extensive intimal proliferation resulting in venous thrombosis and impaired venous return [5]. Many other variants for MTS [6–9] have been described. …”

Section: Discussionmentioning

confidence: 99%

May-Thurner Syndrome: A Case Report and Review of the Literature

Kalu

Shah

Natarajan

et al. 2013

Case Reports in Vascular Medicine

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May-Thurner syndrome (MTS) has been recognized as a clinical entity for almost six decades. The true incidence rate of MTS is unknown and perhaps ranges from 22 to 32% according to the autopsy studies in the early twentieth century. However, MTS related deep venous thrombosis (DVT) accounts for only 2%-3% of all lower limb DVTS. In MTS, the left common iliac vein is compressed against the fifth lumbar vertebrae by the right common iliac artery, as it crosses in front of the vein. Chronic pulsation of the artery is thought to cause elastin, collagen deposition, and intimal fibrosis leading to formation of venous spur and venous thrombosis. MTS can present as acute or chronic DVT leading to pulmonary embolism (PE), chronic leg pain, chronic ulcers, or skin pigmentation changes. In this case report we have described an interesting case of a 28-year-old Caucasian female who presented for evaluation of shortness of breath (SOB) associated with cough for one week. SOB was found to be secondary to massive bilateral pulmonary embolism resulting from extensive MTS related DVT of the left lower extremity. Patient underwent pharmacomechanical treatment with local thrombolysis, thrombectomy, and venoplasty along with stent placement that extended to inferior vena caval junction. Subsequently patient was discharged on coumadin. MTS should be considered in differentials when faced with a case of unilateral DVT particularly in younger age group.

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“…Left iliac vein compression is the most common variant seen in May-Thurner syndrome; however, several other variants have been described in the literature. Compression of the left common iliac vein by the left internal iliac artery, 5) compression of the right common iliac vein by the right internal iliac artery, 6) compression of the IVC by the right common iliac artery 7) and right-sided May-Thurner syndrome in a patient with a left-sided IVC 8) have all been described.…”

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confidence: 99%

Endovascular Management of May-Thurner Syndrome

Ibrahim

Safran

Hasan

et al. 2012

Annals of Vascular Diseases

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May-Thurner syndrome or iliac vein compression syndrome is associated with deep vein thrombosis (DVT) resulting from chronic compression of the left iliac vein against lumbar vertebrae by the overlying right common iliac artery. Historically, May-Thurner syndrome has been treated with anticoagulation therapy. However, this therapy can be problematic when given alone, because it prevents the propagation of the thrombus without eliminating the existing clot. Furthermore, it does not treat the underlying mechanical compression. Consequently, syndrome who was managed by anticoagulation therapy alone, there is a significant chance that the patient will develop recurrent deep vein thrombosis or post thrombotic syndrome or both. Recently, both retrospective and prospective studies have suggested that endovascular management should be front-line treatment; endovascular management actively treats both the mechanical compression with stent placement and the thrombus burden with chemical dissolution. We report our case of 53 years old male patient with May Thurner syndrome who managed by endovascular treatment.

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Retroperitoneal Hematoma Caused by a Ruptured Pelvic Varix in a Patient with Iliac Vein Compression Syndrome

Cited by 23 publications

References 17 publications

Spontaneous retroperitoneal hematoma associated with iliac vein rupture

Spontaneous retroperitoneal hematoma associated with iliac vein rupture

May-Thurner Syndrome: A Case Report and Review of the Literature

Endovascular Management of May-Thurner Syndrome

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