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Caval agenesis with a hypoplastic left kidney in a patient with trauma on warfarin for deep vein thrombosis

Ryan A Lawless1, Dale A Dangleben

  • 1Department of Surgery, Lehigh Valley Health Network, Allentown, PA 18105, USA.

Vascular and Endovascular Surgery
|December 14, 2011
PubMed

Insights

Congenital anomalies of the inferior vena cava (IVC) are rare but can lead to deep vein thrombosis. This case highlights unusual venous collateral pathways in a trauma patient with an intracranial hemorrhage.

Area of Science:

  • Vascular anatomy
  • Medical imaging
  • Clinical case reports

Background:

  • Congenital anomalies of the inferior vena cava (IVC) are uncommon but clinically significant.
  • These anomalies can predispose individuals to deep venous thrombosis (DVT).

Observation:

  • A 50-year-old trauma patient on anticoagulation for DVT experienced an intracranial hemorrhage.
  • Venous return from the lower extremities was identified to be via dilated lumbar venous collaterals into the azygous and hemiazygous systems.
  • A hypoplastic left kidney was also noted as an incidental finding.

Findings:

  • The case demonstrates a rare congenital IVC anomaly presenting with complex venous collateralization.
  • The patient's presentation highlights the potential complications, including intracranial hemorrhage, in patients with DVT and underlying venous anomalies.

Implications:

  • Understanding rare IVC anomalies is crucial for accurate diagnosis and management of venous thromboembolism.
  • This case underscores the importance of comprehensive vascular imaging in trauma patients with unexplained thrombotic events.
  • Recognition of associated anomalies, such as renal hypoplasia, can inform long-term patient care.

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