Extensive deep vein thrombosis in a young girl with absent inferior vena cava and iliac veins: a case report

Abstract

Congenital absence of inferior vena cava (IVC) and iliac veins is a rare anomaly that can predispose young patients to develop deep vein thrombosis (DVT). This case report highlights the importance of considering this anatomical abnormality in young patients with unprovoked DVT. We present the case of a 17-year-old girl who visited the emergency department (ED) complaining of right leg pain and swelling for 8 days. An ED ultrasound revealed extensive DVT in the right leg veins, and further investigation with abdominal computed tomography revealed that the patient’s IVC and iliac veins were absent and showed the presence of thrombosis. The patient underwent thrombectomy and angioplasty by interventional radiology and was given a lifetime prescription for oral anticoagulation. When treating young, otherwise healthy individuals with unprovoked DVT, Clinicians should include absent IVC in their differential when treating young, otherwise healthy patients with unprovoked DVT.

Deep venous thrombosis in patients with atresia of the inferior vena cava and right kidney hypoplasia (KILT syndrome): Systematic review of the literature

“…16,22,28 Direct thrombolysis, mechanical thrombectomy, and balloon angioplasty were performed as the first-line therapy in three patients, followed by long-term anticoagulation. 29,33,40 Thrombosis was recurrent in nine patients (26.5% cases). In three patients, anticoagulation had already been stopped at the time of recurrence (after recurrence, long-term therapy was indicated in two patients, 13,30 and anticoagulation was not possible because of intracranial bleeding in others 26 ); for three patients, there were no data on anticoagulation treatment at the time of thrombosis.…”

“…All articles were published between 1998 and 2023. Sixteen articles were from Europe (four from the United Kingdom, 5,10,12,13 three from Italy, 14–16 three from Spain, 17–19 and one each from Belgium, 20 the Netherlands, 21 Switzerland, 22 Romania, 23 Slovakia, 24 and Poland 25 ), nine from North America (eight from the USA 26–33 and one from Canada 34 ), six from Asia (two from China 35,36 and one each from Japan, 37 Iran, 38 Jordan, 39 and the United Arab Emirates 40 ), and one from Australia. 41…”