Thrombosis of the inferior vena cava and right atrium: a rare complication of an amebic liver abscess in Dakar, Senegal

Even in the absence of Amebic colitis, Amebic liver abscess (ALA) is the most common extraintestinal complication ofEntamoeba histolyticainfection. In the USA, it is most prevalent in middle aged immigrant males from endemic countries such as Africa, Mexico, and India. One of the complications of ALA is inferior vena cava (IVC) thrombosis, which is believed to result from the mechanical compression of the IVC and the consequent thrombogenic nidus elicited from the resultant inflammatory response. There are very few reported cases and even fewer in which the thrombus became a harbinger to pulmonary thromboembolism. We present the case of a 43-year-old male from West Africa who presented with the chief complaint of right upper quadrant abdominal pain for one week associated with persistent nonproductive cough. He had a positive serumEntamoeba histolyticaantibody with CT scan findings of a hepatic abscess with thrombosis of the hepatic vein and inferior vena cava and numerous bilateral pulmonary emboli. This amebic liver abscess was successfully treated with metronidazole and paromomycin, whereas the pulmonary thromboembolism was managed with medical anticoagulation. Based on current knowledge, this is the first reported case in the USA.

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Inferior vena cava obstruction complicating amebic liver abscess

Digestive Diseases and Sciences ◽

10.1007/bf01296740 ◽

1982 ◽

Vol 27 (6) ◽

pp. 565-569 ◽

Cited By ~ 5

Author(s):

Benjamin D. Schmid ◽

Yolanda Lalyre ◽

Bernard Sigel ◽

Reza Kiani ◽

Thomas J. Layden

Keyword(s):

Inferior Vena Cava ◽

Liver Abscess ◽

Inferior Vena ◽

Vena Cava ◽

Amebic Liver Abscess ◽

Inferior Vena Cava Obstruction

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Endovascular Retrieval of a Migrated TrapEase Inferior Vena Cava Filter From the Right Atrium: A Brief Report and Literature Review

Vascular and Endovascular Surgery ◽

10.1177/1538574418760104 ◽

2018 ◽

Vol 52 (4) ◽

pp. 291-294

Author(s):

Andrew J. Gunn ◽

Nathan W. Ertel

Keyword(s):

Inferior Vena Cava ◽

Right Atrium ◽

Inferior Vena ◽

Rare Complication ◽

Vena Cava ◽

Significant Risk ◽

Vena Cava Filters ◽

Surgical Options ◽

Endovascular Approach ◽

The Right

Intracardiac migration is a rare complication of inferior vena cava filters (IVCFs) that poses a significant risk to patients. Both endovascular and surgical options exist, although only a few endovascular options are described in the literature. This brief report describes the endovascular approach used to successfully remove a TrapEase IVCF from the right atrium in a single patient. A brief review of the literature is also provided.

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Amebic Liver Abscess Complicated With Inferior Vena Cava Obstruction

Journal of the Korean Geriatrics Society ◽

10.4235/jkgs.2013.17.4.253 ◽

2013 ◽

Vol 17 (4) ◽

pp. 253-258

Author(s):

Jin Kyeong Cho ◽

Min Sung Kim ◽

Jin Ho Shin ◽

Yeon Sang Jeong ◽

Ga Jin Lim ◽

...

Keyword(s):

Inferior Vena Cava ◽

Liver Abscess ◽

Inferior Vena ◽

Vena Cava ◽

Amebic Liver Abscess ◽

Inferior Vena Cava Obstruction

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A Rare Case of Stenosis at the Inferior Vena Cava to Right Atrium Anastomosis After Bicaval Orthotopic Heart Transplantation

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253219832608 ◽

2019 ◽

Vol 23 (4) ◽

pp. 418-421 ◽

Cited By ~ 3

Author(s):

Benjamin Abrams ◽

Jordan Hoffman ◽

Muhammad Aftab ◽

Jacob Evers ◽

Tamas Seres

Keyword(s):

Inferior Vena Cava ◽

Heart Transplantation ◽

Right Atrium ◽

Inferior Vena ◽

Rare Complication ◽

Vena Cava ◽

Surgical Techniques ◽

Hemodynamic Instability ◽

Organ Injury ◽

Orthotopic Heart Transplantation

Stenosis at either the superior or inferior caval anastomosis is a rare complication of orthotopic heart transplantation (OHT) and is unique to the bicaval surgical technique. The severity of stenosis dictates the degree of clinical significance, varying from asymptomatic to congestive end-organ injury and hemodynamic instability from impaired preload. Due to differences in the anatomic location of organ congestion, the clinical presentation also depends on which of the 2 anastomoses is involved. In this article, the authors describe a case of stenosis at the inferior vena cava to right atrium anastomosis, which was diagnosed intraoperatively during OHT after weaning from cardiopulmonary bypass. Transesophageal echocardiography provided an accurate and timely diagnosis of this complication, which allowed for immediate surgical correction. Surprisingly, a large, native Eustachian valve was found to be obstructing the anastomosis. Resection of the valve relieved the previously significant narrowing across the anastomosis. This case highlights the importance of thorough intraoperative transesophageal echocardiographic evaluation of graft anastomoses during OHT, as well as an understanding on the part of the echocardiographer of the specific surgical techniques employed during OHT.

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Stereotactic Body Radiotherapy Treatment of Child-Pugh C Hepatocellular Carcinoma with Inferior Vena Cava Tumor Thrombus

10.31487/nl.crio.2020.01.02 ◽

2020 ◽

pp. 1-4

Author(s):

Emma C. Fields ◽

Mrudula Bandaru ◽

Scott Matherly ◽

Emma C. Fields

Keyword(s):

Hepatocellular Carcinoma ◽

Inferior Vena Cava ◽

Right Atrium ◽

Stereotactic Body Radiotherapy ◽

Tumor Thrombus ◽

Inferior Vena ◽

Rare Complication ◽

Vena Cava ◽

Response To Treatment ◽

The Right

The presence of tumor thrombus extending into the inferior vena cava (IVC) is a rare complication of hepatocellular carcinoma (HCC), presenting in only 3.8% of patients, resulting in a median survival of 1.9 months. Even rarer and likely with worse outcomes is a tumor extending from the IVC into the right atrium and ventricle. Here we present the case of a 55-year-old male with advanced liver cirrhosis from nonalcoholic steatohepatitis (NASH) with a diagnosis of HCC and IVC tumor thrombus invading into the right atrium and ventricle. The patient was treated with stereotactic body radiotherapy (SBRT) to 30Gy in 5 fractions delivered over 5 days targeting the right atrium, right ventricle and the outflow tract. Initially, the patient had a radiographic and clinical response to treatment, with minimal acute toxicities. Unfortunately, due to declining liver function, the patient subsequently entered hospice care and died 4 months posttreatment. This case demonstrates the poor prognosis of this advanced presentation of disease but suggests that SBRT is a safe and reasonable treatment approach for the reduction of IVC and cardiac tumor thrombus in HCC.

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