Thrombophlebitis of hypogastric and femoral veins

Case contributed by J. Ray Ballinger
Diagnosis almost certain

Presentation

Postpartum female with left leg swelling.

Patient Data

Age: 30 years
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

An axial CT image through the pelvis and thigh show enlargement of the external iliac and superficial femoral veins of the left leg with a non-enhancing filling defect. Note the filling defect in the hypogastric vein as well. Considerable swelling and edema of the left leg is present as compared to the right. A hematoma is noted in the rectus muscle from the recent cesarean section.

This image is a venogram obtained with a catheter placed via the common femoral vein. The tip of the catheter is at the level of the knee. Contrast is seen flowing around an intraluminal filling defect.

Case Discussion

Thrombophlebitis commonly involves the veins of the pelvis and legs as in this case. A thrombus or clot in the deep venous system is at risk of embolizing to the lung. Common causes or predisposing factors include increased coagulation from neoplasms, estrogen use, prolonged sitting, recent surgery, pelvic and femoral fractures and recent childbirth.

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