Inferior Vena Cava Atresia: A Rare Cause of Recurrent Deep Venous Thrombosis and Infected Venous Ulcers

Abstract

Inferior vena cava (IVC) atresia is a rare vascular anomaly and may lead to recurrent deep venous thrombosis (DVT), especially in young adults. It leads to venous stasis due to insufficient drainage from the lower extremities, which in turn contributes to the formation of venous ulcers. Imaging modalities such as computed tomography (CT) or magnetic resonance imaging may aid in diagnosis. There are no specific guidelines regarding anticoagulation for DVTs in these patients, so general principles of management are usually followed. Surgical options are less studied due to the low incidence of the condition and are, therefore, less likely to be advised. In this report, we present a case of a 37-year-old male patient presenting with recurrent DVTs and infected venous ulcers with a delayed incidental diagnosis of IVC atresia on CT imaging.

Keywords: anticoagulation; dvt; ivc atresia; vascular anomaly; venous ulcers.

Figure 1. Right leg venous ulcers on examination

Figure 2. Left leg venous ulcers on examination

Figure 3. CT scan (coronal view) of the abdomen with contrast showing the area of absent IVC (blue arrow) right next to the normal-appearing abdominal aorta (black arrow)

IVC: inferior vena cava

Figure 4. CT angiogram (coronal view) of the chest showing a prominent azygos vein (blue arrow) right next to the normal-appearing thoracic aorta (green arrow)