title: Inferior vena cava anomaly: a risk for deep vein thrombosis.
abstract: BACKGROUND
  Inferior vena cava (IVC) anomalies have a 0.5% incidence rate and could be associated with other congenital abnormalities. In later stage of the disease, trophic ulcers with or without deep vein thrombosis (DVT) is consistent finding.
  
  
  METHODS
  A 29-year-old male patient presented with recurrent lower extremity ulcers. Further workup revealed an absent infrahepatic inferior vena cava, prominently dilated azygos and hemiazygos veins with enlarged retroperitoneal collaterals without DVT.
  
  
  CONCLUSIONS
  IVC anomaly should be suspected in a young patient presenting with unexplained venous thrombosis and recurrent ulcers of a lower extremity. IVC anomaly would inherently lead to blood flow stasis and endothelial injury. Thus per Virchow's triad, other risk factors for hypercoagulability such as physical inactivity, smoking tobacco, oral contraceptive pills should be avoided and when hereditary thrombophilias or other irreversible risk factors are present, lifelong anticoagulation should be considered.
authors.affiliation: Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
authors.forename: Puja S
authors.initials: PS
authors.lastname: Sitwala
authors.affiliation: Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
authors.forename: Vatsal M
authors.initials: VM
authors.lastname: Ladia
authors.affiliation: Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
authors.forename: Parag B
authors.initials: PB
authors.lastname: Brahmbhatt
authors.affiliation: Department of Radiology, Veterans Affairs Medical Center, Johnson City, Tennessee, USA.
authors.forename: Vinay
authors.initials: V
authors.lastname: Jain
authors.affiliation: Department of Internal Medicine, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
authors.forename: Kailash
authors.initials: K
authors.lastname: Bajaj
keywords: Absent; Deep vein thrombosis; Dysgenesis; Inferior vena cava; Trophic ulcers