Inferior vena cava thrombus secondary to blunt abdominal trauma

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Radiology

Background:

• High-speed motor vehicle accidents can cause severe blunt abdominal trauma.
• Injuries to abdominal organs and major vessels are critical concerns in polytrauma.
• Inferior vena cava (IVC) thrombus is a rare complication of blunt abdominal trauma.

Observation:

• A 15-year-old female sustained multiple hepatic lacerations after a high-speed motor vehicle accident.
• A contrast-enhanced CT scan revealed a filling defect in the suprahepatic IVC near the cavoatrial junction.
• This filling defect represented an acute thrombus, diagnosed at the time of initial injury.

Findings:

• The CT findings represent the first reported case of acute IVC thrombus diagnosed via CT in the setting of initial blunt abdominal trauma.
• The thrombus was located in the suprahepatic portion of the IVC, adjacent to the cavoatrial junction.
• Multiple hepatic lacerations were also identified as significant injuries.

Implications:

• This case highlights the possibility of acute IVC thrombus formation secondary to blunt abdominal trauma, even in young patients.
• Management options for this rare entity are not well-established and may include conservative care, anticoagulation, or IVC filter placement.
• Further research is needed to determine optimal treatment strategies for traumatic IVC thrombus.