Malformatie van de V. cava inferior, een risicofactor voor diepveneuze trombose

A 28-year-old man with oedema of both legs as a result of deep venous thrombosis (DVT), was admitted to hospital. The thrombosis was caused by agenesis of the inferior vena cava (VCI). A second patient, a 26-year-old woman, with a history of DVT caused by a hypoplastic VCI and heterozygous factor V Leiden, was referred to an outpatient department for an answer to the question whether pregnancy was safe and wise with her medical history. After a thorough examination and extensive consideration no negative advice concerning pregnancy was given. A third patient, a 29-year-old man, was seen at the same outpatient department with a history of DVT in combination with heterozygosity for the prothrombin 20210A mutation. He had recurrent DVT caused by a hypoplastic VCI. All three patients were treated with oral anticoagulant therapy and stocking support. When young patients present with DVT an anomaly of the VCI should be considered. We suggest CT or MRI imaging to diagnose such an anomaly. The chance of recurrent thrombosis in these patients is high if anticoagulation treatment is withdrawn.