Disease Information for Inferior vena cava obstruction syndrome

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]------

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