Proximal inferior vena cava obstruction without portal hypertension

A case of symptomatic proximal inferior vena cava obstruction was corrected successfully by surgery. Though the nature of the obstruction was not definitively verfied, it probably resulted from persistence of the inferior vena cava valve, or possibly from congenital proximal membrane obstruction. The case illustrates that promimal obstruction of the inferior vena cava may be a surgically correctable lesion but may be overlooked because signs of portal hypertension may be absent and because the usual tests to evaluate edema in the lower extremities may not detect such lesions.