IVC thrombosis in COVID-19

Case contributed by Ian Bickle


Covid infection last month; Grossly swollen left leg. Previously fit and well. Need to exclude malignancy before liaising with vascular surgeons to see whether catheter-directed thrombolysis is appropriate.

Patient Data

Age: 55 years
Gender: Female

Extensive IVC thrombosis.


Extensive venous thrombosis. 

On the right, it extends from the right femoral vein while on the left it commences in the proximal external iliac vein. 

The is distended with thrombus measuring 1.6 cm and extends into the right renal vein and segment 6 of the liver then finishes just below the right atrium.

No solid organ infarct.

No other abnormality.

Case Discussion

COVID-19 is associated with a prothrombotic state.   Many patients have been observed to have pulmonary emboli.

This is an astonishingly large volume of intra-abdominal thrombus with the whole length of the IVC alone distended with thrombus.

Remarkably no end organ damage is evident at the time of the CT.

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