2014 Volume 25 Issue 12 Pages 885-891
Although arterial or intestinal intramural hematoma is frequently observed, no reports have described venous intramural hematoma. We report a 37-year-old man with CT image suggesting an intramural hematoma of the inferior vena cava caused by blunt injury. After being tackled in the right lower abdomen during a rugby game, he was brought to our hospital by ambulance. On arrival, his consciousness was clear, with stable respiration and circulation. Contrast-enhanced abdominal CT revealed right-lateral dominant retroperitoneal hematoma, congestion in the periphery of the right iliac vein, central collapse of the vein, and suggesting almost circumferential intramural hematoma of the inferior vena cava with luminal narrowing. He was diagnosed as retroperitoneal hematoma due to the iliac vein injury and intramural hematoma of the inferior vena cava, caused by tackle energy injury. Conservative management was performed. Although the inferior vena caval intramural hematoma gradually diminished, a thrombus was detected in the peripheral lesion of the right iliac vein. An inferior vena cava filter was inserted, and anticoagulant therapy was initiated. Subsequently, the size of the thrombus of the lower limb vein tended to decrease, and anticoagulant therapy was controlled. After removal of the inferior vena cava filter, he was followed-up as an outpatient.
