Spontaneous iliac vein rupture showed by femoral contrast bolus: A case report

Grüter, A.A.J.; Oudkerk, Sytse F.

doi:10.1016/j.radcr.2022.10.007

Cited by 1 publication

(2 citation statements)

References 9 publications

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“…After full-text screening, 76 cases were included in this systematic review presented in 64 studies from all over the world ( Table 1 ). 2 , 3 , 6 - 67 Most patients underwent open surgery, the first reported in 1961. Endovenous procedures were reported since 2004.…”

Section: Resultsmentioning

confidence: 99%

“…Laparotomy for abdominal decompression and removal of ischemic intestines was of no avail. 66 All conservatively treated patients survived except for 2 cases in which the rupture was missed and one case who died before reaching the hospital. 64 One patient presenting with severe right lower back pain was misdiagnosed with lumbosacral strain and died from cardiac arrest after returning to the ER multiple times.…”

Section: Survivalmentioning

confidence: 98%

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Spontaneous Iliac Vein Ruptures: A Systematic Review

Kooiman

Bakas

Fessem

et al. 2023

Vasc Endovascular Surg

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Introduction Spontaneous iliac vein rupture is a rare, but frequently lethal condition. It is important to timely recognize its clinical features and immediately start adequate treatment. We aimed to increase awareness to clinical features, specific diagnostics, and treatment strategies of spontaneous iliac vein rupture by evaluating the current literature. Methods A systematic search was conducted in EMBASE, Ovid MEDLINE, Cochrane, Web of Science, and Google Scholar from inception until January 23, 2023, without any restrictions. Two reviewers independently screened for eligibility and selected studies describing a spontaneous iliac vein rupture. Patient characteristics, clinical features, diagnostics, treatment strategies, and survival outcomes were collected from included studies. Results We included 76 cases (64 studies) from the literature, mostly presenting with left-sided spontaneous iliac vein rupture (96.1%). Patients were predominantly female (84.2%), had a mean age of 61 years, and frequently presented with a concomitant deep vein thrombosis (DVT) (84.2%). After various follow-up times, 77.6% of the patients survived, either after conservative, endovascular, or open treatment. Endovenous or hybrid procedures were frequently performed if the diagnose was made before treatment, and almost all survived. Open treatment was common if the venous rupture was missed, for some cases leading to death. Conclusion Spontaneous iliac vein rupture is rare and easily missed. The diagnose should at least be considered for middle-aged and elderly females presenting with hemorrhagic shock and concomitant left-sided DVT. There are various treatment strategies for spontaneous iliac vein rupture. An early diagnose brings options for endovenous treatment, which seems to have good survival outcomes based on previously described cases.

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