AGENESIS OF THE HEPATIC SECTION OF THE INFERIOR VENA CAVA AND HEMIAZYGOS CONTINUATION OF THE DUPLICATION OF INFERIOR VENA CAVA, ASSOCIATED WITH SUPERIOR MESENTERIC VEIN THROMBOSIS AND ACUTE ABDOMEN SYMPTOMS. CASE REPORT AND LITERATURE REVIEW.

The agenesis of the hepatic section (absence of hepatosubcardinal anastomosis) of the inferior vena cava associated with its duplication and drainage through the hemiazygos vein is a rare vascular condition coincidentally diagnosed in a young patient with unprovoked deep vein thrombosis. Purpose: we report the case of a young man with no personal or family history of thrombosis, examined on grounds of acute abdomen suspicion and diagnosed with organized primary idiopathic thrombosis of the superior mesenteric vein, due to inferior vena cava abnormalities. Materials and methods: the 26 year-old patient with stage VI CEAP chronic venous insufficiency, leg lymphedema and recently occurred acute abdominal pain was examined by simple thoracic and abdominal X-ray and thoracic abdominal- pelvic computerized tomography scan with contrast medium and by assessment of his inherited vein thromboembolism risk factors. Results: the CT scan revealed segmental thrombosis of the superior mesenteric vein and jejunal vein ischemia associated with several abnormalities of the duplicated inferior vena cava (with congenital absence of its hepatic section). The inherited thrombophilia results were negative and his evolution under symptomatic and anticoagulant therapy (continued in an outpatient clinic, designed to prevent vein thrombosis recurrence) was positive. Conclusions: splanchnic deep vein thrombosis, which is rarely associated with segmental hypo- or agenesis of the inferior vena cava, sometimes allows a coincidental vein abnormality diagnosis. [ABSTRACT FROM AUTHOR]