Post-thrombotic inferior vena caval obstruction. A review of 24 patients

An analysis of the clinical features of 24 patients with post-thrombotic obstruction of the inferior vena cava demonstrated by phlebography showed that the possible precipitating cause was usually trivial and the onset was often associated with bed rest. The classical physical signs of bilateral leg swelling and dilated superficial abdominal wall collateral veins were often absent. In this series bilateral leg swelling was present in 42% and dilated collateral veins were present in half of the patients.A history of recurrent varicose veins and venous ulcers was common and must be taken as an indication for cavography. The presence or absence of proteinuria is no guide to the level of the caval obstruction. The value of inferior vena cavography in making an accurate diagnosis is emphasized.