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Clinical Science

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Case Report

Abstract

Introduction: Deep vein thrombosis (DVT) in young adults is uncommon and typically associated with identifiable risk factors. In cases where DVT occurs without apparent provocation, congenital anatomical anomalies should be considered. May-Thurner Syndrome (MTS), a vascular compression disorder involving the left iliac vein, is a frequently overlooked cause of iliofemoral DVT in young individuals, particularly women.

Case Presentation: A 28-year-old woman with no significant medical history presented with acute left leg swelling, pain, and discoloration, along with new-onset dyspnea and chest discomfort. She had recently transitioned to a contraceptive patch and reported reduced mobility due to fatigue. Imaging confirmed left lower extremity DVT and bilateral pulmonary emboli. Further evaluation revealed compression of the left common iliac vein by the right common iliac artery, consistent with MTS. She underwent successful pulmonary thrombectomy, iliac vein thrombectomy, and stent placement, and was discharged on anticoagulation therapy.

Discussion: This case underscores the importance of evaluating for MTS in young patients with unprovoked or extensive left-sided DVT, especially in the presence of estrogen exposure or prolonged immobility. A definitive diagnosis often requires advanced imaging, and management should address both the acute thrombosis and the underlying anatomical cause to minimize the risk of recurrence.

Conclusion: May-Thurner Syndrome is a critical yet underdiagnosed cause of DVT in young adults. Prompt recognition and targeted treatment can prevent serious complications and lead to improved long-term outcomes.

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Beyond the Clot: A Rare Case of Extensive DVT and Pulmonary Embolism Revealing May-Thurner Syndrome

Introduction: Deep vein thrombosis (DVT) in young adults is uncommon and typically associated with identifiable risk factors. In cases where DVT occurs without apparent provocation, congenital anatomical anomalies should be considered. May-Thurner Syndrome (MTS), a vascular compression disorder involving the left iliac vein, is a frequently overlooked cause of iliofemoral DVT in young individuals, particularly women.

Case Presentation: A 28-year-old woman with no significant medical history presented with acute left leg swelling, pain, and discoloration, along with new-onset dyspnea and chest discomfort. She had recently transitioned to a contraceptive patch and reported reduced mobility due to fatigue. Imaging confirmed left lower extremity DVT and bilateral pulmonary emboli. Further evaluation revealed compression of the left common iliac vein by the right common iliac artery, consistent with MTS. She underwent successful pulmonary thrombectomy, iliac vein thrombectomy, and stent placement, and was discharged on anticoagulation therapy.

Discussion: This case underscores the importance of evaluating for MTS in young patients with unprovoked or extensive left-sided DVT, especially in the presence of estrogen exposure or prolonged immobility. A definitive diagnosis often requires advanced imaging, and management should address both the acute thrombosis and the underlying anatomical cause to minimize the risk of recurrence.

Conclusion: May-Thurner Syndrome is a critical yet underdiagnosed cause of DVT in young adults. Prompt recognition and targeted treatment can prevent serious complications and lead to improved long-term outcomes.

 

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