J Korean Surg Soc.  2006 Aug;71(2):152-155.

Isolated Inferior Vena Cava Thrombosis after Traumatic Hepatic Injury

• Kim YH
• Kang KJ
• Kim HT
• Choi JS
• Lim TJ

Abstract

The incidence of acute deep vein thrombosis after multiple trauma has been reported to range from 1.7 to 10%. In general, a thrombus of the calf vein migrates to the proximal vein. An isolated inferior vena cava (IVC) thrombosis without a peripheral venous thrombosis is rare. A 35-year-old woman was admitted as a result of a large subcapsular hematoma in the right hepatic lobe after a blunt injury caused by an automobile accident. The thrombus in the IVC was detected incidentally during a follow up CT scan three weeks after the trauma. A compression of the IVC by the displaced hepatic parenchyme as a result of a large subcapsular hematoma is a possible mechanism for the IVC thrombosis because there was no distal venous thrombosis and no evidence of hypercoagulability. A retrievable caval filter (Gunther-Tulip(TM), Cook Inc. Bloominton, USA) was placed in the suprarenal vena cava via the right internal jugular venous approach. After placing the retrieval caval filter, aspiration thrombectomy was attempted through the right femoral vein. The luminal patency of the IVC was restored immediately after retrieving the thrombus. The subcapsular hematoma in the right hepatic lobe disappeared two months later and there was no evidence of a residual thrombus in the inferior vena cava.

Keyword

Inferior vena cava; Thrombosis; Hepatic injuries; Hematoma

MeSH Terms

Adult
Automobiles
Female
Femoral Vein
Follow-Up Studies
Hematoma
Humans
Incidence
Multiple Trauma
Phenobarbital
Thrombectomy
Thrombophilia
Thrombosis*
Tomography, X-Ray Computed
Veins
Vena Cava, Inferior*
Venous Thrombosis
Wounds, Nonpenetrating
Phenobarbital