Abstract
Deep venous thrombosis can cause serious complications such as pulmonary embolism. We herein report a case of collateral vein rupture associated with deep venous thrombosis resulting in retroperitoneal hemorrhage. A 75-year-old woman with a 1-week history of pain and swelling in her left lower extremity was transferred to our emergency department because of left-sided lumbar pain. A computed tomography (CT) scan revealed retroperitoneal hemorrhage and extravasation of the contrast media in the venous phase and deep venous thrombosis between the left common iliac vein and left popliteal vein. We suspected bleeding from the left ovarian vein and therefore hospitalized the patient for conservative medical management. On the second day, she underwent angiography to determine the cause of the anemia and CT revealed a recurrence of extravasation. However angiography did not reveal active bleeding. Therefore, the patient was fitted with an inferior vena cava filter and provided conservative medical treatment, after which her symptoms resolved. We surmised the deep venous thrombosis induced an increased perfusion flow in the collateral veins; the resulting increased venous pressure thus caused the rupture of the left ovarian vein. Clinicians must consider retroperitoneal hemorrhage when patients with deep venous thrombosis present with low back pain.
