Venous Thrombosis and Congenital Absence of Inferior Vena Cava in a Patient with Menorrhagia and Pelvic Pain

Abstract 

Background

Agenesis of the inferior vena cava (IVC) is an uncommon congenital vascular malformation. We report a case in a teenage female recently started on oral contraception.

Case

Because of menorrhagia, the patient had begun an oral contraceptive pill (OCP) 1½ months prior to presentation. She initially presented with pelvic and lower back pain, and imaging showed a pelvic deep venous thrombosis (DVT) and an interrupted IVC. Anticoagulation was started, the OCP was discontinued, and a discussion occurred regarding the treatment options for her menorrhagia following her recent diagnosis.

Summary and Conclusion

The case presented shows the rare occurrence of the congenital absence of an IVC with pelvic thrombosis in a young female with a history of menorrhagia and new onset of pelvic pain. The evaluation of this case report leads to a comprehensive review in the treatment choice for menorrhagia with the preceding history of a thrombotic event.

Key Words: Congenital, Interrupted, Absence, Inferior vena cava, IVC, Menorrhagia, Thrombosis, Deep vein thrombosis, DVT, Anticoagulation