Successful surgical treatment of chronic inferior vena caval thrombosis following blunt trauma

Abstract

Posttraumatic inferior vena cava (IVC) thrombosis is extremely rare. We report a case of surgical treatment for chronic inferior vena caval thrombosis 4 years after blunt trauma. A 22-year-old man was referred to our hospital for investigation of an inferior vena caval thrombosis. He had a history of blunt abdominal trauma at age 18 while dismantling a medium truck and had undergone pancreaticojejunostomy for a pancreatic laceration. Computed tomography (CT) scans revealed an inferior vena caval thrombosis extending into the right atrium. Lung perfusion scintigraphy was unremarkable. We performed thrombectomy through a median sternotomy under deep hypothermic circulatory arrest, which gave adequate visualization in a bloodless field. A fiberscope was used intraoperatively for detailed IVC inspection. Postoperative recovery was uneventful, and he was discharged on the 14th postoperative day. Postoperative CT and echocardiography showed no recurrence of the thrombosis.