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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2011 June;24(3):165-8
Conception and clinical consideration of absent infrarenal inferior vena cava
Hu Y., Zhong Q., Li Z., Song Y., Fan S., Shen C., Chen J.
Department of Cardiovascular Surgery, DaPing Hospital, Third Military Medical University, Chongqing, China
Absence of the infrarenal inferior vena cava (IVC) is an extremely rare condition, and its etiology is controversial. It was thought a complete congenital anomaly in previous reports, a failure in the development of the postcardinal and supracardinal veins; while it was prone to be a perinatal IVC thrombosis insulted the formed IVC nowadays. But there is still some puzzling what induced the perinatal IVC thrombosis. Here, we reported a case of absent infrarenal IVC with hypoplasia of intrahepatic IVC, and reviewed all cases of absent infrarenal IVC in the English language medical literature. In all cases of absent infrarenal IVC screening for thrombophilia revealed no alteration, and there was no obvious risk factor of thrombosis in most cases. Besides, we found that some anatomical anomaly of IVC was confirmed combined with the so-called “absent infrarenal IVC” in the reported cases, such as narrow intrahepatic IVC, hypoplastic suprarenal segment, renal vein hypoplasia, or a thick intracaval web inside the renal confluence. For the first time we postulated that the absent infrarenal IVC was possibly induced by perinatal infrarenal IVC thrombus on the basis of IVC anomaly. The aboving makes DVT (deep venous thrombosis) in the cases with an absent infrarenal IVC different. The remarkable features of DVT could give a clue for the diagnosis of absent infrarenal IVC, such as significantly in younger patients, no other precipitating factors or clotting defects, affecting the iliac veins frequently, bilateral thrombosis, and recurrent DVT. Treatment strategies nowadays possibly depended on the severity of symptom.