title: Congenital abnormalities of the inferior vena cava presenting clinically in adolescent males.
abstract: BACKGROUND
  Congenital anatomic abnormality of the inferior vena cava (IVC) is an important risk factor for the development of spontaneous proximal lower extremity deep vein thrombosis (DVT) in young adults. The incidence of DVT associated with congenital IVC anomalies in paediatric populations has not been described, and the implications of IVC anomalies for treatment and outcomes of DVT are unknown.
  
  
  METHODS
  This study reports a series of five adolescent males with spontaneous lower extremity DVTs and underlying congenital IVC abnormalities. Cases were identified by searching the institutional database of patients treated with anticoagulation for venous thromboembolism at a tertiary children's hospital.
  
  
  RESULTS
  The demographics, clinical presentations, imaging findings, treatment courses, and outcomes are described. All cases occurred in males, and accounted for approximately twenty percent of adolescent males presenting with DVT.
  
  
  CONCLUSIONS
  IVC abnormality is likely an under-recognized risk factor for DVT in this age group, and detailed vascular imaging should be pursued in adolescents with spontaneous proximal lower extremity DVT when initial ultrasonography does not delineate the proximal clot extent. Management requires individual risk-benefit assessment in the context of providing developmentally appropriate care. Further research is required to establish long-term outcomes and determine optimal treatment strategies.
authors: Division of Hematology / Oncology / BMT, BC Children's Hospital B315, 4480 Oak St., Vancouver, BC V6H 3 V4, Canada. Electronic address: jhalparin@cw.bc.ca.
authors: Jessica
authors: J
authors: Halparin
authors: Clinical Haematology Department, Royal Children's Hospital, 50 Flemington Rd., Parkville, Vic, 3052 Australia; Department of Paediatrics, The University of Melbourne; Haematology Research, Murdoch Childrens Research Institute. Electronic address: paul.monagle@rch.org.au.
authors: Paul
authors: P
authors: Monagle
authors: Clinical Haematology Department, Royal Children's Hospital, 50 Flemington Rd., Parkville, Vic, 3052 Australia; Departments of Paediatrics and Nursing, The University of Melbourne; Haematology Research, Murdoch Childrens Research Institute; Nursing Research Department, The Royal Children's Hospital. Electronic address: fiona.newall@rch.org.au.
authors: Fiona
authors: F
authors: Newall
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D035002:Lower Extremity; D008297:Male; D012307:Risk Factors; D014682:Vena Cava, Inferior / Q000002:abnormalities*; D054556:Venous Thromboembolism / Q000209:etiology*; D020246:Venous Thrombosis / Q000209:etiology*
keywords: Anticoagulation; Deep vein thrombosis; Inferior vena cava; Pediatric thrombosis; Pediatrics