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In all studies, age of presentation of first thrombosis has been less than 30 years of age and incidence is similar in men and women. Few studies consider double inferior vena cava to be the cause of DVT, perhaps because it causes retrograde stasis less often. Compensatory drainage thru the thoracic-lumbar, pelvic, and abdominal veins can cause symptoms in the thorax, hypogastrium, lumbar, and genital regions, prior to those typical of DVT of the lower extremities. Early detection could warn of the presence of cava malformations in young patients. For instance our patient presented complaining of chest and abdominal pain, with associated discoloration of her left lower limb.
Some authors believe cava malformation alone can provoke DVT, but the fact that lifelong asymptomatic malformations occur, the findings in the case report and the status of thrombosis as a multifactorial illness, suggest the presence of associated factors, both congenital and acquired. The complementary entities of the patient's heterozygosity for the Factor V Leiden mutation, and her use of an oral contraceptive intrauterine device, could invariably have been adjunctive triggers in her clotting cascade.
Journal of Hematology & Oncology 2008;1:24-

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