A 42-year-old female patient presented to the Emergency Department (ED) for unilateral edema involving the entire left lower limb that had been rapidly progressing in the last 24 h. It was associated with blueish skin discolouration and moderate pain (Fig. 1A). The rest of the clinical examination was normal. Regarding medical history, the patient was previously healthy, used oral oestroprogestative contraception, and was an active smoker. In the ED, laboratory findings revealed an hyperleukocytosis of 15.38 G/L and an elevated C-Reactive Protein (CRP) leveling at 134.2 mg/L. Given the high clinical probability of deep vein thrombosis (DVT), a venous Doppler ultrasound was performed, revealing a deep thrombosis of the common femoral vein, extending to the deep femoral vein and the popliteal vein. To investigate the extension of the thrombosis and possible downstream compression of the femoral vein, an injected abdominopelvic CT scan was performed (Fig. 1B-C). This confirmed complete venous thrombosis of the left iliofemoral venous network and demonstrated compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) close to the common iliac vein’ bifurcation.
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Published online: March 12, 2023
Accepted: March 6, 2023
Received: December 22, 2022
Publication stageIn Press Corrected Proof
© 2023 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.