J Korean Soc Emerg Med.  2017 Oct;28(5):539-546. 10.0000/jksem.2017.28.5.539.

A Case of May-Thurner Syndrome with Extensive Deep Vein Thrombosis and Extraperitoneal Hematoma from Spontaneous Utero-ovarian Vein Rupture

• Chung H

• KMID: 2394404
• DOI: http://doi.org/10.0000/jksem.2017.28.5.539

Abstract

May-Thurner syndrome, also known as iliac vein compression syndrome, is an anatomically variable condition that is characterized by left common iliac vein compression by the right common iliac artery and the lumbar vertebra. This chronic and pulsatile venous compression by the right common iliac artery can cause local intimal injury, inflammation, scarring, and fibrosis, leading to venous outflow obstruction and increased intraluminal pressure. This can cause several complications, such as venous insufficiency, venous claudication, deep vein thrombosis, and very rarely extraperitoneal hematoma due to spontaneous iliac vein rupture. In particular, in middle aged women, hormonal imbalance coupled with these mechanical and inflammatory factors can cause further weakening of the venous wall integrity and develop spontaneous and potentially lethal venous rupture. This paper reports an extremely rare case of a 58-year-old woman with May-Thurner syndrome with acute and extensive deep vein thrombosis of the left lower extremity and a spontaneous extraperitoneal hematoma caused by utero-ovarian vein rupture.

Keyword

May-Thurner syndrome; Venous thrombosis; Vascular system injuries; Vein; Abdominal cavity

MeSH Terms

Abdominal Cavity
Cicatrix
Female
Fibrosis
Hematoma*
Humans
Iliac Artery
Iliac Vein
Inflammation
Lower Extremity
May-Thurner Syndrome*
Middle Aged
Rupture*
Spine
Vascular System Injuries
Veins*
Venous Insufficiency
Venous Thrombosis*