Congenital Inferior Vena Cava Agenesis with Ulceration and Deep Vein Thrombosis

This is one of the few case reports of congenital inferior vena cava atresia (IVCA) with extensive bilateral lower extremity ulcers.

IVCA is a congenital anomaly characterized by poor venous return in the lower extremities with increased risk of deep vein thrombi (DVTs) and, rarely, non-healing ulcers.

A 45-year-old woman with history significant for DVTs presented with extensive bilateral lower extremity ulcers, and a CT scan revealed congenital IVCA. Oedema management, DVT prevention, routine wound care and skin grafts resolved the ulcers.

Congenital venous abnormalities should be included in the differential diagnosis of multiple unprovoked DVTs and non-healing ulcers.

There are very few reports in the English literature describing inferior vena cava atresia with extensive bilateral lower extremity ulcers.We present our findings as well as new insights into the congenital causes of bilateral lower extremity ulcers and deep vein thrombi (DVTs).Especially for young adults with a history of multiple DVTs and non-healing ulcers, venous abnormalities should be included in the differential diagnosis and advanced imaging should be utilized.