Inferior Vena Cava Thrombus Secondary to Ureteropelvic Junction Obstruction with Severe Hydronephrosis

Abstract

: Benign external compression of the inferior vena cava (IVC) with distal thrombus formation is seldomly described in the medical literature. We report a case of external IVC compression by a dilated right renal pelvis and hydronephrotic kidney secondary to longstanding ureteropelvic junction (UPJ) obstruction found in a 68-year-old male. Management included therapeutic anticoagulation, IVC filter placement, attempted thrombectomy by interventional radiology and interval repeat imaging. This patient demonstrated complete resolution of the caval thrombus on repeat imaging 2 months following discharge. This case highlights the importance of interdisciplinary team coordination, a crucial component of this patient’s management and eventual treatment plan. It is reasonable to manage patients with IVC thrombus with anticoagulation alone. In the modern era, angiointerventional techniques provide for minimally invasive approaches to the management of vascular disorders and minimize morbidity.