PMC4364575_01
Multi-detector computed tomography (MDCT) on admission. A and B. Transverse plane (A) and coronal plane (B) at the ilio-cava junction level. Left external iliac vein (lt EIV) branches off directly from the inferior vena cava. The left EIA is compressed by the abdominal aorta (*) with thrombus; C to E. Transverse plane (C and E) and coronal plane (D and F) at the iliofemoral vein level. Lt EIV, right common iliac vein (rt CIV), left internal iliac vein (lt IIV) and left femoral vein (let FV) have thrombi; G. left popliteal vein thrombus (white arrow); H. thrombi of left lower leg veins/soleal veins (white arrows).
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PMC4364575_01_12959_2015_45_Fig1_HTML.jpg
Fig1
Multi-detector computed tomography (MDCT) showed massive deep vein thrombosis from the lower edge of inferior vena cava to the lower leg veins (Figure 1). This patient had a congenital anomaly of the iliac vein in which the left external iliac vein (EIV) and left internal iliac vein (IIV) separately branched off from the inferior vena cava without a left common iliac vein (Figure 1A). The left EIV was compressed by the abdominal aorta and the fifth lumbar vertebra (Figure 1A and B). The left IIV also had a large thrombus (Figure 1C and D).
MDCT at day 22. A and B. Transverse plane (A) and coronal plane (B) at the ilio-cava junction level. * Abdominal aorta. Iliac vein compression persists, but the contrast defect has disappeared (white arrow); C to E. Transverse plane (C and E) and coronal plane (D and F) at the iliofemoral vein level. Thrombi shown in Figure 1 have disappeared (white arrow); G. Absence of the left popliteal vein thrombus (white arrow); H. Absence of the left lower leg vein thrombus (white arrows).
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PMC4364575_01_12959_2015_45_Fig2_HTML.jpg
Fig2
Surprisingly, the massive DVT in his left leg had almost completely disappeared according to MDCT performed on day 22 of the treatment (Figure 2).