RESUMEN
INTRODUCTION: Inferior vena cava agenesis (IVCA) is one of the many anomalies of this vessel. It is one of the most uncommon anomalies, with an estimated prevalence of 0.0005-1% in the general population. Around 5% of the patients younger than 30 years with a diagnosis of deep vein thrombosis (DVT) have a total or segmental IVCA. REPORT: Here two unique cases of young and previously healthy male patients are reported: one with bilateral lower extremity DVT, the second with lower extremity DVT and pulmonary embolism. Both patients were found to have segmental agenesis of the inferior vena cava on computed tomography angiography (CTA). Treatment consisted of ultrasound enhanced thrombolysis (EKOS + alteplase) and venous angioplasty. Both patients were discharged with long-term (up to 24 months) oral anticoagulation and compression stockings. Follow up at 3 and 12 months revealed no new thrombotic episode. DISCUSSION: IVCA can be asymptomatic but the majority of the symptomatic patients present with DVT. IVCA confers a risk factor for DVT. IVCA should be considered and ruled out as a rare but important risk factor and cause of DVT in previously young healthy patients. Once diagnosed, aggressive treatment must be started because of the high risk of post-thrombotic syndrome.
RESUMEN
Heterotaxy syndrome is defined as an abnormal arrangement of some organs and vessels in association with dysmorphism. The authors describe the case of a patient with heterotaxy syndrome with poliesplenia incidentally diagnosed during imaging evaluation (computed tomography and small bowel barium study) of unrelated pathological condition.
Síndrome heterotáxica é definida como um arranjo anormal de alguns órgãos e vasos em associação a dismorfismo. Descrevemos o caso de uma paciente com síndrome heterotáxica diagnosticada incidentalmente durante avaliação por imagem (tomografia computadorizada e radiografia contrastada do intestino delgado) de condição patológica não relacionada.
RESUMEN
La agenesia de vena cava inferior (VCI) es una patología poco frecuente que suele diagnosticarse a raíz de una trombosis venosa secundaria sintomática de las venas ilíacas. Presentamos el caso de un varón de 28 años que acude al centro de salud por dolor en miembros inferiores y datos de insuficiencia venosa. Se visualiza mediante ecografía trombosis venosa profunda (TVP) bilateral.(AU)
Agenesis of the inferior vena cava (IVC) is a rare condition usually diagnosed as secondary to symptomatic deep venous thrombosis of iliac veins. We report a 28-year-old male that was admitted in the medical center due to pain in both legs and history of venous insufficiency. Ultrasound reveáis bilateral deep venous thrombosis.(AU)
RESUMEN
La agenesia de vena cava inferior (VCI) es una patología poco frecuente que suele diagnosticarse a raíz de una trombosis venosa secundaria sintomática de las venas ilíacas. Presentamos el caso de un varón de 28 años que acude al centro de salud por dolor en miembros inferiores y datos de insuficiencia venosa. Se visualiza mediante ecografía trombosis venosa profunda (TVP) bilateral.(AU)
Agenesis of the inferior vena cava (IVC) is a rare condition usually diagnosed as secondary to symptomatic deep venous thrombosis of iliac veins. We report a 28-year-old male that was admitted in the medical center due to pain in both legs and history of venous insufficiency. Ultrasound reveáis bilateral deep venous thrombosis.(AU)