May-Thurner syndrome with inferior mesenteric vein drainage and porta system - Case report

Abstract

We present the case of a 12-year-old girl with a history of vascular anomalies in the lower pelvic limbs and back, who developed unilateral deep vein thrombosis of the left lower limb after her pubertal development, she was diagnosed with May-Thurner syndrome with an abnormal venous drainage of the pelvic structures through the superior hemorrhoidal veins to the inferior mesenteric vein towards the porta system, this being a chronic manifestation. This kind of behavior has not been documented in the reviewed medical literature. Secondarily, balloon angioplasty was performed without breaking the stenotic ring. As a second attempt, it was decided to place the venous stent, with satisfactory resolution of the symptoms. There are controversies about the indications for the use of anticoagulants and antiplatelet agents, or the indications to place a venous stent in children. We must consider an approach to for effective therapeutic treatment in these cases is to control bleeding, the main goal being trying to avoid ulcerations in the lower limb due to venous insufficiency with irreversible affectation of the valvular system.

Keywords

• Case report
• May-Thurner
• extremity deep vein thrombosis
• Iliac vein
• Venous stent
• Inferior mesenteric vein drainage