These Hips Don't Lie: Deep Vein Thrombosis in an Adolescent With an Inferior Vena Cava Anomaly

Area of Science:

• Vascular Surgery
• Pediatric Cardiology
• Radiology

Background:

• Congenital anomalies of the inferior vena cava (IVC) are rare but can increase the risk of venous thromboembolism, particularly in younger populations.
• Deep vein thrombosis (DVT) in adolescents is uncommon and often associated with acquired risk factors, making congenital causes a diagnostic challenge.

Purpose of the Study:

• To report a case of extensive deep vein thrombosis in an adolescent secondary to an interrupted inferior vena cava.
• To highlight the importance of considering congenital IVC anomalies in the differential diagnosis of unexplained DVT in pediatric patients.

Main Methods:

• A 13-year-old male presented with acute left hip pain following a sports injury.
• Diagnostic imaging revealed extensive deep vein thrombosis.
• Genetic and anatomical investigations identified an interrupted inferior vena cava as the underlying cause.

Main Results:

• The patient was diagnosed with extensive deep vein thrombosis attributed to an interrupted inferior vena cava.
• Treatment involved catheter-directed thrombolysis to dissolve the clot and anticoagulation therapy to prevent recurrence.
• Symptoms of hip pain resolved completely post-intervention.

Conclusions:

• An interrupted inferior vena cava can present insidiously in adolescents, manifesting as deep vein thrombosis after minor trauma.
• Early diagnosis and appropriate management, including thrombolysis and anticoagulation, are crucial for favorable outcomes in pediatric DVT associated with IVC anomalies.