Management of inferior vena cava thrombosis after blunt liver injury

Abstract

Inferior vena cava (IVC) thrombosis after traumatic liver injury is an extremely rare condition, and only 12 cases have been reported in the English literature since 1911. We report a case of a 26-year-old man who presented with IVC thrombosis after blunt liver injury. IVC thrombosis was incidentally detected by computed tomography 15 days after conservative management of blunt liver injury. The patient denied any symptoms of thrombophlebitis and did not have any evidence of hypercoagulable state. We placed an IVC filter via the right jugular vein and started the anticoagulation treatment. The patient recovered successfully without operative treatment and IVC thrombosis disappeared completely two months later. We suggest that that the possibility of IVC thrombosis should be considered in patients with a large hematoma of the liver, which may cause compression of the IVC.

Keywords: Hematoma; Inferior vena cava; Liver injury; Thrombosis.

Fig. 1

Computed tomography scan on admission showing multiple liver lacerations.

Fig. 2

Follow-up abdominal CT on the follow-up day 5 showing a slight decrease in the size of parenchymal hematoma.

Fig. 3

A repeat abdominal CT on the follow-up day 15 showing significant improvement in hepatic laceration (A) and a large free-floating thrombus in the IVC (white arrow) (B).

Fig. 4

IVC filter insertion via the right jugular vein.

Fig. 5

A vascular CT on the follow-up day 60 showing disappearance of IVC thrombosis and a marked decrease in the liquefied hematoma of the liver.