Chronic IVC thrombosis
Venous leg ulcer.
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Non-opacification of the IVC, which is markedly attenuated and fibrotic. Non-opacification of the left common iliac vein.
Patent and dilated distal right CIV drained into a dilated paraspinal vein. Dilated anterior abdominal wall superficial veins and dilated hemiazygous and paraspinal veins
Non-opacification of the right popliteal vein and left deep venous system. Dilated subcutaneous varicosities bilaterally. Patent left lesser and great saphenous veins bilaterally.
Incidentally noted left ectopic pelvic kidney.
The most common cause of IVC thrombosis is the congenital IVC anomalies. Otherwise, the other causes are the same as that of the lower limb DVT.
The majority of patients with lower extremities DVT do not have IVC thrombosis. Hence, screening all DVT patients for IVC thrombosis can be tedious, low-yield, and not cost-effective.
The literature suggests that screening for IVC thrombosis is reasonable among patients with a lower extremity DVT with high-risk features such bilateral DVT and/or proximal iliofemoral DVT as in our case.