Impacted ureteric stone causing iliofemoral vein thrombosis: The first reported case

Area of Science:

• Urology
• Vascular Surgery
• Nephrology

Background:

• Extrinsic compression of iliac veins is a known cause of deep vein thrombosis (DVT).
• Pelvic pathologies can lead to venous obstruction and thrombosis.
• Ureteric stones are typically associated with urinary symptoms, not venous complications.

Purpose of the Study:

• To report a unique case of deep vein thrombosis (DVT) caused by an impacted ureteric stone.
• To highlight the diagnostic challenge and management of this rare presentation.
• To emphasize the association between pelvic pathology and iliofemoral DVT.

Main Methods:

• A 65-year-old male presented with unilateral lower limb swelling.
• Diagnosis of extensive deep vein thrombosis (DVT) was confirmed.
• Incidental finding of a severely hydronephrotic left kidney and an impacted ureteric stone compressing iliac vessels.
• Management included percutaneous nephrostomy followed by ureterolithotripsy.

Main Results:

• The patient was diagnosed with extensive left-sided deep vein thrombosis (DVT).
• An impacted left ureteric stone was identified as the cause of extrinsic compression on the iliac vessels.
• Successful management of both the DVT and the ureteric stone was achieved.

Conclusions:

• Impacted ureteric stones can cause significant extrinsic compression leading to life-threatening proximal deep vein thrombosis (DVT).
• This is the first reported case of ureteric stone-induced iliofemoral DVT.
• Isolated unilateral iliofemoral DVT should prompt investigation for underlying pelvic pathologies, including ureteric stones.