PMC5813843_01
Swelling and bluish discoloration of the skin of lowest hypogastrium due to thrombosed collateral veins (arrow).
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The patient was afebrile with no signs of inflammation (Figure 1).
Axial maximum intensity projection (MIP) CT image showing the serpentiform varicose vein connecting the two common femoral veins (circle marker). The venous collateral appears unspecified due to the presence of thrombus which is also seen freely floating inside the right common femoral vein (arrowhead).
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Initially, an ultrasound (US) and computed tomography (CT) of the lesion were performed showing thrombosed veins with no signs of flow within the vessels (Figure 2).
(a) Axial CT image showing the left common femoral vein appearing thread-like in size and unopacified due to suspected chronic thrombosis. Note the asymmetry with the average right size. (b) Curved reconstructed CT image showing the exact course of the collateral vein which is seen connecting the two common femoral veins. Note is made of the freely floating thrombus occupying the whole extent of the collateral and partially the common femoral vein lumen (arrow). (c) Three-dimensional (3D) volume rendering reconstructed CT image showing the collateral vein and the common femoral veins in three dimensions. (d) Virtual reconstruction of arterial phase.
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The left external iliac vein (EIV) was occluded with signs of chronic thrombosis as its lumen was collapsed (Figure 3(a)-(d)).