Diagnosis and resection of a giant ovarian cyst presenting in a young patient with contralateral back pain and lower limb deep vein thrombosis

2021 ◽  
Vol 14 (3) ◽  
pp. e239673
Author(s):  
Duranka Perera ◽  
Anita K Bolina ◽  
Nazneen Hoque ◽  
Khalil Razvi
Keyword(s):  
Deep Vein Thrombosis ◽  
Back Pain ◽  
Ovarian Cyst ◽  
Vena Cava ◽  
Large Mass ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Reactive Protein ◽  
The Right ◽  
Deep Vein

We present a case of a giant ovarian cyst in a 20-year-old woman who presented atypically at our Emergency Department with left-sided back pain followed by acute left leg swelling. Blood tests showed significantly raised C-Reactive Protein and D-Dimer. CT-Abdomen-Pelvis demonstrated a large mass in the region of the right ovary with suspicious heterogeneous filling defects in the left external iliac vein, confirmed as a left-sided deep-vein thrombosis on ultrasound Doppler. MRI revealed the lesion to be cystic and the deep venous thrombosis was treated with twice-daily Clexane. Prior to removal of the cyst, an Inferior Vena Cava Filter was placed to reduce thromboembolic risk. The cyst was resected without complication and the postoperative period was uneventful. This case occurred while face-to-face services were limited by COVID-19 and illustrates the need for robust systemic measures to safeguard patients against the emergency sequelae of insidious gynaecological pathology.

scholarly journals Primary Iliac Venous Leiomyosarcoma: A Rare Cause of Deep Vein Thrombosis in a Young Patient

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Nelson Oliveira ◽  
Emanuel Dias ◽  
Ricardo Lima ◽  
Fernando Oliveira ◽  
Isabel Cássio
Keyword(s):  
Deep Vein Thrombosis ◽  
Vena Cava ◽  
Young Patients ◽  
Iliac Vein ◽  
Definitive Diagnosis ◽  
Systemic Thrombolysis ◽  
Vein Thrombosis ◽  
Phlegmasia Alba ◽  
The Right ◽  
Deep Vein

Introduction. Primary venous tumours are a rare cause of deep vein thrombosis. The authors present a case where the definitive diagnosis was delayed by inconclusive complementary imaging.Clinical Case. A thirty-seven-year-old female presented with an iliofemoral venous thrombosis of the right lower limb. The patient had presented with an episode of femoral-popliteal vein thrombosis five months before and was currently under anticoagulation.Phlegmasia alba dolensinstalled progressively, as thrombus rapidly extended to the inferior vena cava despite systemic thrombolysis and anticoagulation. Diagnostic imaging failed to identify the underlying aetiology of the deep vein thrombosis. The definitive diagnosis of primary venous leiomyosarcoma was reached by a subcutaneous abdominal wall nodule biopsy.Conclusion. Primary venous leiomyosarcoma of the iliac vein is a rare cause of deep vein thrombosis, which must be considered in young patients with recurrent or refractory to treatment deep vein thrombosis.

Compression of the right iliac vein in asymptomatic subjects and patients with iliofemoral deep vein thrombosis

2016 ◽  
Vol 31 (7) ◽  
pp. 471-480 ◽  
Author(s):  
Feng Chen ◽  
Jun Deng ◽  
Xiao M Hu ◽  
Wei M Zhou
Keyword(s):  
Computed Tomography ◽  
Deep Vein Thrombosis ◽  
Iliac Artery ◽  
Iliac Vein ◽  
Vein Thrombosis ◽  
Computed Tomography Images ◽  
Iliac Vein Compression ◽  
The Right ◽  
Asymptomatic Subjects ◽  
Deep Vein

Objective To evaluate right iliac vein and left iliac vein compression in asymptomatic subjects, right-sided and left-sided iliofemoral deep vein thrombosis patients. Methods A retrospective analysis of records and computed tomography images was conducted in 200 asymptomatic subjects (male:female, 100:100). A prospective analysis was conducted in 79 consecutive deep vein thrombosis patients (left:right deep vein thrombosis, 47:32) who had undergone contrast-enhanced computed tomography examination. The minor diameter and percentage compression of the iliac vein were evaluated. Results In asymptomatic subjects, 13.5% had right iliac vein compression >50%, 2.0% had right iliac vein compression >70%, mean compression was 23.48%; 45.0% had left iliac vein compression >50% and 17.0% had left iliac vein compression >70%, mean compression was 47.58%. Right iliac vein sandwiched between the right external iliac artery and the right internal iliac artery was the most common compression pattern (59.26%). Males had higher right iliac vein compression than the females (male:female, 26.29%:20.68%, P < 0.001). Mean percentage compression of the right iliac vein was higher in right deep vein thrombosis patients than in left deep vein thrombosis patients (right:left deep vein thrombosis, 48.54%:22.29%, P < 0.001). Conclusion Similar to left iliac vein compression, right iliac vein compression was a frequent imaging finding in CT and represented a normal anatomic pattern. Right deep vein thrombosis patients had more serious right iliac vein compression than left deep vein thrombosis patients, and further research is required on the association of right iliac vein compression with right iliofemoral deep vein thrombosis.

scholarly journals Epidural Venous Plexus Engorgement: What Lies Beneath?

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
Fuldem Yildirim Donmez
Keyword(s):  
Deep Vein Thrombosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Iliac Vein ◽  
Venous Plexus ◽  
Vein Thrombosis ◽  
Venous Circulation ◽  
Epidural Vein ◽  
Deep Vein

Epidural venous plexus engorgement may occur due to several conditions that prevent the normal venous circulation. Inferior vena cava agenesis is a very rare cause of epidural venous enlargement. We present a case with a very thin inferior vena cava and left iliac vein agenesis who presented with back pain due to epidural vein engorgement and lacked other venous problems such as deep vein thrombosis.

scholarly journals Nonnegligible causes of symptoms of acute lower extremities——3 cases of May-Thurner syndrome with deep vein thrombosis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yi Sun ◽  
Shenghan Song
Keyword(s):  
Computed Tomography ◽  
Deep Vein Thrombosis ◽  
Iliac Vein ◽  
Lower Limbs ◽  
Common Iliac Vein ◽  
Vein Thrombosis ◽  
Left Common Iliac Vein ◽  
Catheter Directed Thrombolysis ◽  
The Right ◽  
Deep Vein

Background May-Thurner syndrome is a kind of disease caused by the compression of the left common iliac vein. It is one of the causes of incomplete venous valves and superficial varicose veins in lower limbs, and is also a potential factor of acute deep vein thrombosis (DVT). Method Here 3 cases are diagnosed as May-Thurner syndrome at different ages. Case presentations 1. A 35-year-old female patient was hospitalized with swelling of the left lower limb for 1 week. Computed tomography (CT) showed compression of the left common iliac vein with thrombosis. May-Thurner syndrome was diagnosed and catheter-directed thrombolysis was performed. 2. A 37-year-old male patient came to our hospital due to sudden swelling of the right lower extremity and pain for 3 days. Computed tomography showed compression of the left common iliac vein and deep venous thrombosis (DVT) of the right iliac vein. May-Thurner syndrome was diagnosed. The patient was performed with inferior vena cava (IVC) filter implantation, catheter-directed thrombolysis and balloon angioplasty for right iliac vein. And the patient recovered well; 3. A 55-year-old female patient came to our hospital with swelling and discomfort in the left lower extremity for 3 days. Computed tomography showed stenosis of the left common iliac vein with deep vein thrombosis. May-Thurner syndrome was diagnosed, balloon dilation and stent implantation were performed. During 3 years of follow-up, there was no swelling or new thrombosis in her lower limbs. Conclusion When encountering unexplained deep vein thrombosis, iliac vein compression syndrome should be considered and treated in time to prevent the recurrence of thrombosis. Catheter-directed thrombolysis can relieve symptoms and stenting placement is the optimal way to relieve stenosis, supplemented by long-term anticoagulation therapy and graduated compression stockings.

scholarly journals A Guitaring Technique with 035 Wire and Perforated Coronary Balloon for Thrombolysis in the Treatment of Acute Deep Vein Thrombosis

2019 ◽  
Vol 5 (3) ◽  
pp. 104-107
Author(s):  
Mark Christopher Arokiaraj
Keyword(s):  
Deep Vein Thrombosis ◽  
Femoral Vein ◽  
Vena Cava ◽  
Good Resolution ◽  
Vein Thrombosis ◽  
Femoral Vessels ◽  
Acute Deep Vein Thrombosis ◽  
The Right ◽  
Diagnostic Catheter ◽  
Deep Vein

Abstract A patient who underwent thrombolysis and inferior vena cava filter implantation for acute deep vein thrombosis treatment nine years before, presented with deep vein thrombosis on the other limb. The venous angiogram showed deep vein thrombosis in the ilio-femoral vessels. Through left femoral vein puncture, a 6F right Judkins diagnostic catheter was advanced up to the proximal iliac veins, and further advancement was not possible. Hence, a 035 hydrophilic wire was advanced, and through a guitaring technique, the clots were disrupted at the mid-thigh level. Through a 014 coronary wire, a punctured coronary balloon was placed at the distal mid-thigh level, and intravascular thrombolysis was performed for 12 hours, followed by removal of the balloon and the right coronary Judkins catheters. The leg swelling reduced in the first day, and subsequently, the patient was followed up for 7 months with anticoagulation and good resolution of the symptoms.

Standards for recanalisation of chronic venous outflow obstructions

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 259-266 ◽  
Author(s):  
Michael Lichtenberg ◽  
Rick de Graaf ◽  
Christian Erbel
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Symptoms ◽  
Vena Cava ◽  
Iliac Vein ◽  
Venous Hypertension ◽  
Postthrombotic Syndrome ◽  
Venous Outflow ◽  
Vein Thrombosis ◽  
Technical Developments ◽  
Deep Vein

Abstract. Postthrombotic syndrome (PTS) is the most common complication after iliofemoral deep vein thrombosis. It reduces quality of life and increases deep vein thrombosis (DVT)-related costs. The clinical symptoms and severity of PTS may vary; the most common symptoms include edema, pain (venous claudication), hyperpigmentation, lipodermatosclerosis, and ulceration. PTS is based on the principle of outflow obstruction, which may be caused by venous hypertension and may lead to valvular damage and venous reflux or insufficiency. Recent technical developments and new stent techniques now allow recanalisation of even complex venous outflow obstructions within the iliac vein and the inferior vena cava. This manuscript gives an overview on the latest standards for venous recanalisation.

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