Congenitally absent inferior vena cava presenting in adulthood with venous stasis and ulceration: a surgically treated case. 1996

M J Dougherty, and K D Calligaro, and D A DeLaurentis
Section of Vascular Surgery, Pennsylvania Hospital, Thomas Jefferson University, Philadelphia, USA.

Absence of the inferior vena cava (IVC) is an uncommon congenital abnormality. Symptoms of lower extremity venous insufficiency resulting from this anatomic abnormality have been reported only once in the English literature, and no experience with surgical treatment of this condition has been published. We report the case of an otherwise healthy 41-year-old man with an 18-month history of severe venous insufficiency involving the right leg manifested by extensive ulceration that did not respond to aggressive conservative treatment. Duplex findings were not suggestive of venous obstruction or reflux, but venography documented no filling of the common iliac vein or inferior vena cava, and outflow was via collaterals to the azygous and hemiazygous systems. Computed tomography demonstrated complete absence of the inferior vena cava with azygous continuation. A prosthetic bypass from the external iliac to the intrathoracic azygous vein was performed with complete symptomatic relief after a 30-month follow-up period. Venous bypass surgery may play a role in treatment of this rare cause of venous insufficiency.

UI MeSH Term Description Entries
D007084 Iliac Vein A vein on either side of the body which is formed by the union of the external and internal iliac veins and passes upward to join with its fellow of the opposite side to form the inferior vena cava. Deep Circumflex Iliac Vein,Iliac Veins,Vein, Iliac,Veins, Iliac
D008297 Male Males
D001807 Blood Vessel Prosthesis Device constructed of either synthetic or biological material that is used for the repair of injured or diseased blood vessels. Vascular Prosthesis,Blood Vessel Prostheses,Tissue-Engineered Vascular Graft,Graft, Tissue-Engineered Vascular,Grafts, Tissue-Engineered Vascular,Prostheses, Blood Vessel,Prostheses, Vascular,Prosthesis, Blood Vessel,Prosthesis, Vascular,Tissue Engineered Vascular Graft,Tissue-Engineered Vascular Grafts,Vascular Graft, Tissue-Engineered,Vascular Grafts, Tissue-Engineered,Vascular Prostheses,Vessel Prostheses, Blood,Vessel Prosthesis, Blood
D004487 Edema Abnormal fluid accumulation in TISSUES or body cavities. Most cases of edema are present under the SKIN in SUBCUTANEOUS TISSUE. Dropsy,Hydrops,Anasarca
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001401 Azygos Vein A vein which arises from the right ascending lumbar vein or the vena cava, enters the thorax through the aortic orifice in the diaphragm, and terminates in the superior vena cava. Azygos Veins,Vein, Azygos,Veins, Azygos
D014647 Varicose Ulcer Skin breakdown or ulceration in the drainage area of a VARICOSE VEIN, usually in the leg. Stasis Ulcer,Venous Ulcer,Venous Hypertension Ulcers,Venous Stasis Ulcers,Hypertension Ulcer, Venous,Hypertension Ulcers, Venous,Stasis Ulcer, Venous,Stasis Ulcers,Stasis Ulcers, Venous,Ulcer, Stasis,Ulcer, Varicose,Ulcer, Venous,Ulcer, Venous Hypertension,Ulcer, Venous Stasis,Ulcers, Stasis,Ulcers, Varicose,Ulcers, Venous,Ulcers, Venous Hypertension,Ulcers, Venous Stasis,Varicose Ulcers,Venous Hypertension Ulcer,Venous Stasis Ulcer,Venous Ulcers
D014682 Vena Cava, Inferior The venous trunk which receives blood from the lower extremities and from the pelvic and abdominal organs. Inferior Vena Cava,Inferior Vena Cavas,Vena Cavas, Inferior
D014689 Venous Insufficiency Impaired venous blood flow or venous return (venous stasis), usually caused by inadequate venous valves. Venous insufficiency often occurs in the legs, and is associated with EDEMA and sometimes with VENOUS STASIS ULCERS at the ankle. Insufficiencies, Venous,Insufficiency, Venous,Venous Insufficiencies

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