Diverticulum of the inferior vena cava: a case report.

Anomalies of the inferior vena cava are rare. We describe a case of diverticulum arising from the inferior vena cava, which has not been described to date.     

Leiomyosarcoma of the inferior vena cava: a case report

Leiomyosarcoma (LMS) of the inferior vena cava (IVC) is a rare vascular tumour, with about 200 cases reported since 1871. The Authors report a case of leiomyosarcoma of the suprarenal inferior vena cava preoperatively diagnosed by ultrasonography and computed tomography. A surgical resection and venous wall reconstruction was performed. Complete surgical resection with a tumour-free margin (1 cm) is the treatment of choice. Neoadjuvant therapy may be given to downsize the tumour and increase resectability rate. When complete resection is not possible, debulking combined with radiation therapy provides good palliation.     

下腔静脉平滑肌肉瘤1例

[病例简介]女,66岁.无明显诱因上腹部持续性胀痛1个月,上腹部皮肤发热入院.无恶心、呕吐及放射痛,无尿频、尿急、尿痛及血尿.查体：腹部饱满,未见肠型及蠕动波,右上腹部压痛,无明显反跳痛,肝脾肋下未触及,肝、肾区无叩痛,无移动性浊音,肠鸣音正常,双下肢无水肿.[第一段]     

Perinatal inferior vena cava thrombosis and absence of the infrarenal inferior vena cava

We report a case of infrarenal absence of the inferior vena cava (IVC) presenting as a major iliofemoral deep venous thrombosis in an adolescent. This is the first report of infrarenal IVC absence in which IVC thrombosis has been demonstrated in the perinatal period. We propose an association between perinatal IVC thrombosis and subsequent infrarenal IVC absence. In addition, the case demonstrates the importance of assessment for anatomical anomalies in patients presenting with apparently idiopathic deep venous thrombosis.     

Post traumatic inferior vena cava thrombosis: A case report and review of literature

IntroductionPost traumatic inferior vena cava (IVC) thrombosis is a rare and not well described entity with nonspecific clinical presentation. It remains a therapeutic challenge in traumatic context because of haemorrhagic risk due to anticoagulation.Presentation of caseWe report a case of IVC thrombosis in an 18 year-old man who presented with liver injury following a traffic crash. The thrombosis was incidentally diagnosed on admission by computed tomography. The patient was managed conservatively without anticoagulation initially considering the increasing haemorrhagic risk. IVC filter placing was not possible because of the unusual localization of the thrombus. Unfractionated heparin was started on the third day after CT scan control showing stability of hepatic lesions with occurrence of a pulmonary embolism. The final outcome was good.DiscussionThe management of post traumatic IVC thrombosis is not well described. Medical approach consists in conservative management with anticoagulation which requires the absence of active bleeding lesions. Surgical treatment is commonly based on thrombectomy under extracorporeal circulation. Interventional vascular techniques have become an important alternative approach for the treatment of many vessel lesions. Their main advantages are the relative ease and speed with which they can be performed.ConclusionPost traumatic IVC thrombosis is a rare condition. Its management is not well defined. Early anticoagulation should be discussed on a case-by-case basis. Other alternatives such IVC filter or surgical thrombectomy may be used when the bleeding risk is increased. The most serious risk is pulmonary embolism. Outcome can be favorable even with non surgical approaches.     

Leiomyosarcoma of the inferior vena cava: a new case report

We report on a new case of leiomyosarcoma of the inferior vena cava presenting as an abdominal mass. With the help of review of the literature, the value of modern imaging techniques is recalled. The treatment is exclusively surgical. The prognosis is poor due almost to the diagnosis delay.     

Membranous obstruction of the inferior vena cava.

Membranous obstruction of the inferior vena cava (MOVC) is a rare clinical entity. The incidence is higher in Japan and Africa than that in USA and Europe. MOVC is considered to be different from the Budd-Chiari syndrome. There are differences in clinical manifestation and pathologic changes in the liver. Findings of the liver revealed cirrhosis in all patients but in one. Ascites and esophageal varices could be observed in 79% and in 58% of the patients, respectively. According to Sugiura''s classification, they consisted of Type Ia in 63%, Type Ib in 11%, Type II in 11%, and Type III in 16%. Portopulmonary shunt by splenopneumopexy was successfully performed on 19 patients with MOVC in this clinic, of which diagnosis was established by cavography.     

Pheochromocytoma with extension into the inferior vena cava: a case report.

Eleven cases of pheochromocytoma with extension into the inferior vena cava have been reported previously. This report describes a case of a right adrenal pheochromocytoma with extension into the inferior vena cava that was removed with the aid of cardiopulmonary bypass and circulatory arrest.     

Multidisciplinary management of testicular cancer complicated by thrombosis of the inferior vena cava: a case report

Introduction: Testicular cancer is a rare disease, most commonly seen in young adults. It represents 1% of solid cancers in men. Inferior vena cava (IVC) thrombosis remains a rare complication of testicular cancer and is often associated with a high risk of pulmonary embolism (PE).

Case report: The authors report a case of a 26-year-old man presenting with advanced testicular cancer, left-sided retroperitoneal metastasis and parietal infiltration of the IVC complicated with thrombosis of the left iliac vein and the IVC, both responsible for PE.

Discussion: A multidisciplinary management which included curative excision of the lesions, placement of a temporary IVC filter and adjuvant chemotherapy permitted an optimal approach. No complications occurred and the post-operative healing was uneventful. No recurrences were observed on the long-term follow-up.

Conclusions: IVC Thrombosis is a rare complication that should be taken into consideration when diagnosing testicular cancer. Prompt diagnosis is crucial to minimize the risk of PE which can be life-threatening.     

Vena cava filters and inferior vena cava thrombosis

OBJECTIVE: Retrievable vena cava filters (R-VCF) are a recent addition to the therapeutic armamentarium for the prevention of pulmonary embolism. However, unlike permanent vena cava filters (P-VCF), outcomes data are limited regarding complication rates. METHODS: This was a retrospective comparative analysis of consecutive patients undergoing placement of R-VCF vs P-VCF at Wake Forest University School of Medicine from January 2000 to December 2004. Data collected included demographics, procedural specifics, filter type, indications, and complications. Summary data are expressed as number (percentage) or mean +/- SD. Continuous and categorical variables were analyzed by using t and Fisher exact testing, as appropriate. Four additional patients with vena cava thrombosis were also referred to our institution for treatment during the study period, all with opposed biconical VCFs (OptEase and TrapEase filters) recently placed at other facilities. This last group of patients is described but not included in the analysis. RESULTS: A total of 189 VCF (165 P-VCF and 24 R-VCF) cases were examined. No significant differences in VCF groups were observed according to age, documented hypercoagulability, or concomitant anticoagulation. Significant differences were observed according to sex (30.3% of P-VCF vs 62.5% of R-VCF patients were female), morbid obesity (4.2% of P-VCF vs 25% of R-VCF patients), active malignancy (20% of P-VCF vs 41.7% of R-VCF patients), and indication for VCF placement. Over a median follow-up of 8.5 months, no case of significant hemorrhage, no VCF migration, and four cases of vena cava thrombosis were observed. Vena cava thrombosis was observed more frequently in the presence of R-VCF when compared with P-VCF (12.5% vs 0.6%; P = .007). All observed vena cava thromboses were associated with severe clinical symptoms and occurred in patients who received opposed biconical VCF designs. CONCLUSIONS: In our experience, both P-VCF and R-VCF can be placed safely. Among both permanent and retrievable devices, however, opposed biconical designs seem to be associated with an increased risk for vena cava thrombosis. Although causative factors remain unclear, filter design and resultant flow dynamics may play an important role, because all episodes of vena cava thrombosis occurred in patients with a single-filter design.     

Post-traumatic inferior vena caval thrombosis: case report

Thrombosis of the aorta and inferior vena cava is a rare sequela of blunt abdominal trauma. Inferior vena caval thrombosis developed in a 55-year-old man after blunt abdominal trauma. It was detected 18 days after injury through the use of computed tomography. The patient was treated with a Greenfield filter and anticoagulation.     

Traumatic thrombosis of the inferior vena cava

Traumatic thrombosis of vena cava is rare. Thrombosis of the inferior vena cava diagnosed by uroscanner after blunt abdominal trauma involving the kidney is reported. The Doppler exam confirmed the floating character of the clot. Three days after the initiation of anticoagulant therapy, the thrombus disappeared without any clinical or radiological signs of pulmonary embolism. Fifteen cases of traumatic thrombosis of the inferior vena cava have been described in the literature. Mechanisms, clinical pictures and the management are discussed.     

Idiopathic aneurysm of the inferior vena cava. A case report

A 13-year-old girl complained of sudden abdominal pain and shortly thereafter collapsed and died of massive pulmonary embolism. The source of the embolism was an idiopathic aneurysm of the inferior vena cava, which had thrombosed after partial rupture.