Successful Surgical Management of Pelvic Congestion and Lower Extremity Swelling Owing to Absence of Infrarenal Inferior Vena Cava

Inferior vena cava (IVC) thrombosis remains under-recognised as it is often not pursued as a primary diagnosis. The aetiology of IVC thrombosis can be divided into congenital versus acquired, with all aetiological factors found among Virchow's triad of stasis, injury and hypercoagulability. Signs and symptoms are related to aetiology and range from no symptoms to cardiovascular collapse. Painful lower limb swelling combined with lower back pain, pyrexia, dilatation of cutaneous abdominal wall veins and a concurrent rise in inflammatory markers are suggestive of IVC thrombosis. Following initial lower limb venous duplex, magnetic resonance imaging (MRI) is the optimal non-invasive imaging tool. Aetiology directs treatment, which ranges from anticoagulation and lower limb compression to open surgery, with endovascular therapies increasingly favoured. The objective of this review is to assess current literature on the aetiology, presentation, investigation, treatment, prognosis and other factors pertaining to IVC thrombosis.

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“…94 Surgical bypass with interposition PTFE graft has also been performed, though experience is minimal. 95,96 …”

Section: Thrombosis Treatment In Congenital Ivc Anomalymentioning

confidence: 99%

Inferior vena cava thrombosis: A review of current practice

et al. 2013

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“…The association between absence of IVC and pelvic varices causing PCS is weak and has been documented only in a few case reports [3] , [10] , [11] . Congenital anomalies of the venous system leading to obstruction of venous drainage are a well-recognized cause of this condition.…”

Section: Discussionmentioning

confidence: 99%

Pelvic congestion syndrome due to agenesis of the infrarenal inferior vena cava

Menezes

Haider

Al-Douri

et al. 2019

Radiology Case Reports

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The inferior vena cava (IVC) is the main conduit of venous return to the right atrium from the lower extremities and abdominal organs. Agenesis of the IVC has an incidence of <1% in the general population [1], although it has been reported in the literature as occurring in up to 8.7% of the population [2]. Patients with absent IVC may present with symptoms of lower extremity venous insufficiency [6], idiopathic deep venous thrombosis [7], or pelvic congestion syndrome. To our knowledge there have only been a few cases reported in the literature of agenesis of the IVC associated with pelvic congestion syndrome [3,10,11]. We present another interesting case of pelvic congestion syndrome due to absent IVC.

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“…Treatment is directed towards prevention of thrombosis formation or recurrence; life-long vitamin K antagonist is required for patients with IVCA in addition to elastic stocking and leg elevation to relieve venous stasis [ 1 , 2 , 8 , 15 ]. Surgical correction can be an option for management depending on the severity of the venous stasis symptoms and response to medical and conservative treatment [ 11 , 14 , 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis

Haddad

Saadaldin

Kumar

et al. 2015

Case Reports in Vascular Medicine

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Inferior vena cava agenesis (IVCA) is a rare congenital anomaly that can be asymptomatic or present with vague, nonspecific symptoms, such as abdominal or lower back pain, or deep vein thrombosis (DVT). Here, we present a 55-year-old male who came with painless swelling and redness of his left lower limb. On examination, swelling and redness were noted extending from the left foot to the upper thigh; it was also warm compared to his right lower limb. Venous Doppler ultrasound was done which showed DVT extending up to the common femoral vein. Subsequently, computed-tomography (CT) of the chest and abdomen was done to exclude malignancy or venous flow obstruction; it revealed congenital absence (agenesis) of the infrarenal inferior vena cava (IVC).

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Successful Surgical Management of Pelvic Congestion and Lower Extremity Swelling Owing to Absence of Infrarenal Inferior Vena Cava

Cited by 20 publications

References 14 publications

Inferior vena cava thrombosis: A review of current practice

Inferior vena cava thrombosis: A review of current practice

Pelvic congestion syndrome due to agenesis of the infrarenal inferior vena cava

Deep Vein Thrombosis Provoked by Inferior Vena Cava Agenesis

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