Popliteal Vein Aneurysm in Association with Inferior Vena Caval Obstruction Secondary to Hemochromatosis-Induced Hepatocellular Carcinoma

摘要

A 59-year-old man with hereditary hemochromatosis-induced cirrhosis and secondary diabetes mellitus presented with recurrent superficial phlebitis of his right leg. A venous duplex examination demonstrated an incompetent saphenofemoraljunction, a dilated great saphenous vein, and an incidental above-knee saccular popliteal vein aneurysm. No thrombus was identified, and venous flow was attenuated. Although the patient was advised to undergo anticoagulationimmediately, he deferred warfarin treatment to commence after his holiday abroad. Upon returning home, he developed sudden onset of shortness of breath. Computed tomographic (CT) pulmonary angiography demonstrated multiple pulmonary emboli (PE). A CT venogram did not show any evidence of deep vein thrombosis (Fig 1). The patient received anticoagulation with low-molecular-weight heparin and was discharged home on warfarin. Elective surgical repair of his popliteal vein aneurysm was planned in 5 months at completion of his anticoagulation therapy.