BILATERAL DEEP VEIN THROMBOSIS ASSOCIATED WITH AGENESIS OF THE INFERIOR VENA CAVA. (#21801)
Introducción
Inferior vena cava agenesis (IVCA) is a rare congenital anomaly and a risk factor for deep vein thrombosis (DVT). Congenital anomalies of the vena cava are divided into three anatomical types:
Infrarenal (Most common)
Renal
Suprarenal
Most cases are diagnosed after an episode of deep vein thrombosis with no apparent cause in young patients. There are few reports of IVCA, with it being reported in only 0.0005 to 1% of the global population. Therefore, the risk of thromboembolic disease and the appropriate management concerning conservative anticoagulant treatment or invasive measures such as intraluminal venous filters are not well understood.
Caso
A 32-year-old male patient presented with pain (8/10), edema, and functional impairment in both lower limbs. A venous Doppler ultrasound was performed, revealing venous thrombosis up to the saphenofemoral junction in both lower limbs. A contrast-enhanced chest, abdomen, and pelvis CT scan showed the absence of the infrahepatic segment of the IVC, which was replaced by the azygos system, aberrantly dilated due to compensatory collateral flow. Venous catheterization was performed with placement of a venous filter in the retrohepatic portion of the azygos system. Anticoagulation was initiated with enoxaparin, followed by eventual bridging with acenocoumarol, and due to good symptom progression, the patient was discharged from the hospital.
Comentario
The purpose of this presentation is to raise awareness among healthcare professionals about this rare presentation, given its increasing incidence due to advances in imaging studies, which allow for the evaluation of the entire vascular system, or in this case, the absence of its components.
Conclusión
IVCA continues to be considered a rare cause of deep vein thrombosis, primarily due to the underdiagnosis of congenital malformations worldwide. However, in the context of the presented patient, it was observed that it can lead to extensive occlusions in the lower limbs, requiring an intraluminal filter and subsequent long-term anticoagulant treatment to prevent further recurrences. We hope that the presentation of this uncommon case will guide readers to consider structural defects as potential causes of DVT in young patients, especially given the lack of bibliographic material and established consensus on its management.
Tipo: Caso clinico
Palabras clave: Inferior vena cava,Thrombosis,Agenesis
Categorias: Medicina Vascular, Hematología
Institución: HEA Dr. Ramón Madariaga
Ciudad: Posadas , Misiones
País: Argentina
Autores