Disease Information for Inferior vena cava obstruction syndrome

Clinical Manifestations
Signs & Symptoms
Bilateral ankle swelling
Bilateral leg edema/swelling
Bilateral severe leg edema
Bilateral thigh edema
Inguinal/axillary vein dilated/flows upward/bilateral
Postural Hypotension Non-neural
Thorax/vein distension
Increased ankle pigmentation/stasis
Scrotal edema/swelling
Swelling of scrotum
Abdominal venous engorgement/collaterals
Abdominal wall edema
Chest/truncal venous distension
Edema of Lower Extremities
Legs itch on standing
Acutely ill patient/signs
Disease Progression
Diagnostic Test Results
Xray/Abdominal calcifications/ABD
Xray/Abdominal film abnormalities/ABD/KUB
Venogram Lower Extremity abnormal
Associated Diseases & Rule outs
Associated Disease & Complications
Acute Renal Failure
Ascites in Elderly
Hepatic vein thrombosis (Budd-Chiari)
Phlegmasia cerulea dolens
Stasis dermatitis/ankles
Disease Mechanism & Classification
Specific Agent
Pathophysiology/Hepatic Congestion
CLASS/Cardiovascular (category)
CLASS/Great vessels disorder (ex)
CLASS/Vascular disorder (ex).
CLASS/Vein disorder (ex).
Pathophysiology/Post-sinusoidal Portal Hypertension
PROCESS/Arteriosclerosis/vascular/venous (category)
PROCESS/Structural/anatomic/foreign body (category)
PROCESS/Inflammatory/Vascular/venous/phlebitis (ex)

CASE: severe dyspnoea and pitting edema in the lower limbs; He has a history of recurrent deep venous thrombosis and pulmonary embolism; jugular venous pressure is markedly raised, and the appearance of his abdomen is grossly abnormal; several grossly dilated tortuous veins; One especially prominent vessel runs through the centre of the epigastrium; the patient has a serious obstruction of the inferior vena cava; The most likely cause of obstruction of the inferior vena cava is a malignant tumour spreading from one of the abdominal viscera; Obstruction of the inferior vena cava was first described by William Osler in 1879, however, at that time it was a diagnosis generally made after death; Nowadays the diagnosis can be made during life, with the help of modern imaging modalities; The clinical diagnosis may be confirmed using plain radiographs, computed tomography scanning or ultrasound;

If the obstruction is above the renal veins then these vessels may also clot, causing nephrotic syndrome; thrombosis in the inferior vena cava may predispose the patient to recurrent pulmonary emboli; Stephen Bicknell consultant physician, Gartnavel General Hospital, Glasgow

June 2004 case --[BMJ.com google search 2006]------


External Links Related to Inferior vena cava obstruction syndrome
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)