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Spontaneous Iliac Vein Rupture.

Kim DH, Park HS, Lee T - Vasc Specialist Int (2015)

Bottom Line: Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation.Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding.This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.

No MeSH data available.


Related in: MedlinePlus

Computed tomography finding showing pulmonary thromboembolism (A) at initial presentation with thrombus was annotated. (B) At 2 months follow-up. Thrombus was not observed. (C, D) Abdominopelvic computed tomography finding at 2 months follow-up showing a decreased hematoma around the medial side of the left external iliac vein was annotated by arrows.
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f2-vsi-31-62: Computed tomography finding showing pulmonary thromboembolism (A) at initial presentation with thrombus was annotated. (B) At 2 months follow-up. Thrombus was not observed. (C, D) Abdominopelvic computed tomography finding at 2 months follow-up showing a decreased hematoma around the medial side of the left external iliac vein was annotated by arrows.

Mentions: The next day, a follow-up CT was performed, in which the hematoma was still present in the retroperitoneal cavity but without any evidence of active bleeding. The extent of DVT had not changed either, and pulmonary thromboembolism (PTE) was found in both main pulmonary arteries (Fig. 2A). Therefore insertion of an inferior vena cava (IVC) filter was performed. RBC transfusion was continued due to a decrease in hemoglobin and hematocrit from 8.8 g/dL and 26.2% to 7.9 g/dL and 23.7%, respectively. From the third day onwards, follow up blood tests were normalized and vital signs were stable, and on the fourth hospital day, she was moved to the general ward.


Spontaneous Iliac Vein Rupture.

Kim DH, Park HS, Lee T - Vasc Specialist Int (2015)

Computed tomography finding showing pulmonary thromboembolism (A) at initial presentation with thrombus was annotated. (B) At 2 months follow-up. Thrombus was not observed. (C, D) Abdominopelvic computed tomography finding at 2 months follow-up showing a decreased hematoma around the medial side of the left external iliac vein was annotated by arrows.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4508654&req=5

f2-vsi-31-62: Computed tomography finding showing pulmonary thromboembolism (A) at initial presentation with thrombus was annotated. (B) At 2 months follow-up. Thrombus was not observed. (C, D) Abdominopelvic computed tomography finding at 2 months follow-up showing a decreased hematoma around the medial side of the left external iliac vein was annotated by arrows.
Mentions: The next day, a follow-up CT was performed, in which the hematoma was still present in the retroperitoneal cavity but without any evidence of active bleeding. The extent of DVT had not changed either, and pulmonary thromboembolism (PTE) was found in both main pulmonary arteries (Fig. 2A). Therefore insertion of an inferior vena cava (IVC) filter was performed. RBC transfusion was continued due to a decrease in hemoglobin and hematocrit from 8.8 g/dL and 26.2% to 7.9 g/dL and 23.7%, respectively. From the third day onwards, follow up blood tests were normalized and vital signs were stable, and on the fourth hospital day, she was moved to the general ward.

Bottom Line: Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation.Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding.This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.

ABSTRACT
Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding.

No MeSH data available.


Related in: MedlinePlus