PDF(Pubmed)
Abstract：
Venous duplications, particularly in the femoral vein, are rare anatomical variations that can complicate the clinical presentation and management of deep venous thrombosis (DVT). This case describes an elderly female who was diagnosed by her primary care physician with a left lower extremity DVT one week prior to her presentation and had been prescribed Xarelto. Despite strict adherence to therapy, her left leg pain, swelling, and discoloration worsened, prompting her hospital admission. On physical examination, her left leg was markedly swollen, violaceous, and tender. A repeat compression ultrasound upon admission revealed an occlusive thrombus within the left common femoral vein. Given the diagnosis of phlegmasia, cerulea dolens, the patient was at risk for irreversible venous gangrene and possible limb loss. Therefore, she was taken to the operating room for venography and a mechanical thrombectomy. Venography of the left lower extremity uncovered an extensive thrombus within a complete duplication of the left femoral vein, as well as in the left common femoral and iliac veins. Thrombosis in a duplicated femoral vein, though rare, is a significant clinical entity. This case highlights the importance of considering anatomical anomalies in patients with refractory symptoms and emphasizes the role of detailed imaging for accurate diagnosis and tailored treatment.
摘要：
静脉重复,尤其是股静脉,是罕见的解剖变异，可使深静脉血栓形成（DVT）的临床表现和管理复杂化。该病例描述了一名老年女性，她在就诊前一周被其初级保健医生诊断为左下肢DVT，并接受了Xarelto处方。尽管严格遵守治疗，她的左腿疼痛,肿胀,变色恶化，促使她入院.在体检时，她的左腿明显肿胀，小提琴,和招标。入院时重复加压超声检查显示左股总静脉内存在闭塞性血栓。鉴于痰的诊断，ceruleadolens,患者有发生不可逆的静脉坏疽和可能的肢体丧失的风险.因此,她被带到手术室进行静脉造影和机械血栓切除术。左下肢静脉造影发现左股静脉完全重复内有广泛的血栓，以及左股总静脉和髂总静脉。重复的股静脉血栓形成，虽然罕见，是一个重要的临床实体。该病例强调了考虑难治性症状患者解剖异常的重要性，并强调了详细成像对准确诊断和量身定制治疗的作用。
