Inferior Vena Caval Thrombosis Differential Diagnoses

Updated: Aug 01, 2017
  • Author: Luis G Fernandez, MD, FACS, FASAS, FCCP, FCCM, FICS, KHS; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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DDx

Diagnostic Considerations

Because patients with inferior vena caval (IVC) thrombosis (IVCT) may present with a variety of signs and symptoms, the diagnosis can be challenging. Using a system to classify the symptoms (eg, predominantly thrombotic in origin or predominantly embolic in nature) may aid in the diagnosis.

Thrombosis occurring at the level of the renal veins raises the possibility of renal cell carcinoma (RCC). However, more commonly, thrombosis at this level suggests a nephrotic syndrome.

The clinician must have a profound awareness of the associated elements that make up the clinical complex of congenital vena caval thrombosis in order to avoid diagnostic and treatment pitfalls. In addition, knowledge of the association of other anomalies in patients with an absent IVC, such as renal atrophy or agenesis, can highlight underlying vascular anomalies, which are in and of themselves of significant clinical importance. With physician awareness of the possibility of IVCT in various situations, the patient is more likely to receive prompt diagnosis and subsequent intervention that minimizes ensuing sequelae.