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Trapped vessel of abdominal pain with hepatomegaly: A case report

Sirisha Grandhe1, Joy A Lee2, Ankur Chandra3

  • 1Department of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, CA 95817, United States.

World Journal of Hepatology
|December 12, 2018
PubMed

Insights

Inferior vena cava (IVC) obstruction can cause abdominal pain and elevated liver enzymes. Physicians should consider diaphragm compression as a rare cause of IVC constriction, prompting vascular surgery referral.

Area of Science:

  • Hepatology
  • Vascular Surgery
  • Gastroenterology

Background:

  • Abdominal pain and elevated transaminases often prompt investigation for inferior vena cava (IVC) obstruction.
  • Common causes of IVC obstruction include clotting disorders and trauma, but these may not explain all cases.

Observation:

  • A unique case of abdominal pain and hepatomegaly was observed, stemming from IVC constriction.
  • The constriction was caused by extrinsic compression from the diaphragm.

Findings:

  • This case highlights diaphragm-induced extrinsic compression as a potential, albeit rare, cause of IVC constriction.
  • Physicians should assess IVC diameter and consider extrinsic compression in unexplained cases.

Implications:

  • Recognizing diaphragmatic compression of the IVC is crucial for accurate diagnosis and management.
  • Early referral to vascular surgery is recommended for confirmed IVC compression for timely intervention.

Keywords:
Abdominal painHepatic circulationIschemia/reperfusionLiver imaging

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