Inferior vena cava syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Inferior vena cava syndrome (IVCS) is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.

Frequency

Epidemiological data is elusive owing to the wide variety of clinical presentation. In the U.S., incidence is estimated to be at 5–10 cases per 100'000 per year.

Causes

• Obstruction by deep vein thrombosis or tumors (most commonly renal cell carcinoma)
• Compression through external pressure by neighbouring structures or tumors, either by significantly compressing the vein or by promoting thrombosis by causing turbulence by disturbing the blood flow. This is quite common during the third trimester of pregnancy when the uterus compresses the vein in the right side position.
• Iatrogenic causes may be suspected in patients with a medical history of liver transplantation, vascular catheters, dialysis and other invasive procedures in the vicinity
• Budd-Chiari syndrome

Symptoms

IVCS presents with a wide variety of signs and symptoms, making it difficult to diagnose clinically.

• Edema of the lower extremities
• Tachycardia
• In pregnant women, signs of fetal hypoxia and distress may be seen in the CTG

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