Inferior vena cava syndrome

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Luke Rusowicz-Orazem, B.S.

Inferior vena cava syndrome (IVCS) is a result of obstruction of the inferior vena cava. It can be caused by invasion or compression by a pathological process or by thrombosis in the vein itself.

Frequency

Epidemiological data is elusive owing to the wide variety of clinical presentation. In the U.S., incidence is estimated to be at 5–10 cases per 100'000 per year.

Causes

Common Causes

• Abdominal aortic aneurysm
• Acute pancreatitis
• Adrenal cortical carcinoma
• Budd-chiari syndrome
• Deep vein thrombosis
• Gastric adenocarcinoma
• Hepatic abscess
• Hepatic hemangioma
• Hepatic venous thrombosis
• Infective phlebitis
• Pancreatic pseudocysts 
• Renal vein thrombosis 
• Seminoma
• Teratoma
• Tumors
• Uterus pressure
• Vascular catheterization
• Vena caval filters

Causes by Organ System

Cardiovascular	Abdominal aortic aneurysm, Deep vein thrombosis, Hepatic venous thrombosis, Infective phlebitis, Pacemaker wires, Renal vein thrombosis , Vascular catheterization , Vena caval filters
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Oral contraceptives
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	Abdominal aortic aneurysm, Acute pancreatitis, Budd-chiari syndrome, Gastric adenocarcinoma, Hepatic abscess, Hepatic hemangioma, Hepatic venous thrombosis, Liver transplants, Pancreatic pseudocysts , Psoa hematoma, Retroperitoneal fibrosis, Retroperitoneal leiomyosarcoma
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	Liver transplants, Pacemaker wires, Vascular catheterization , Vena caval filters
Infectious Disease	Hepatic abscess, Infective phlebitis, Polycystitis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Adrenal cortical carcinoma
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	Uterus pressure
Oncologic	Adrenal cortical carcinoma, Gastric adenocarcinoma, Hepatic hemangioma, Pancreatic pseudocysts , Psoa hematoma, Renal angiomyolipoma, Renal cell carcinoma, Retroperitoneal leiomyosarcoma, Seminoma, Teratoma, Tumors
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal/Electrolyte	Dialysis, Nephrotic syndrome, Polycystitis, Renal angiomyolipoma, Renal cell carcinoma, Renal vein thrombosis
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Abdominal aortic aneurysm
• Acute pancreatitis
• Adrenal cortical carcinoma
• Budd-chiari syndrome
• Deep vein thrombosis
• Dialysis
• Gastric adenocarcinoma
• Hepatic abscess
• Hepatic hemangioma
• Hepatic venous thrombosis
• Infective phlebitis
• Liver transplants
• Nephrotic syndrome
• Oral contraceptives
• Pacemaker wires
• Pancreatic pseudocysts 
• Physical trauma
• Polycystitis
• Psoa hematoma
• Renal angiomyolipoma
• Renal cell carcinoma
• Renal vein thrombosis 
• Retroperitoneal fibrosis
• Retroperitoneal leiomyosarcoma
• Seminoma
• Teratoma
• Tumors
• Uterus pressure
• Vascular catheterization
• Vena caval filters

Symptoms

IVCS presents with a wide variety of signs and symptoms, making it difficult to diagnose clinically.

• Edema of the lower extremities
• Tachycardia
• In pregnant women, signs of fetal hypoxia and distress may be seen in the CTG

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