Thrombophlebitis of prepubic veins in patient with Aplasia of the left common and left external iliac veins: Case report

A congenital defect of some of the large veins that drain blood from the lower extremity is a very rare occurrence and, considering the clinical consequences, it is generally diagnosed at a relatively early age - in childhood or youth. Within the complex classification of vascular malformations, a special category is comprised of large blood vessel malformations, also called truncal vascular malformations. In comparison to other anomalies, aplasia or lack of development of a certain segment in the deep venous systems, potentially has the most serious hemodynamic consequences. The appearance of varicose veins, through which the venous blood is drained distally to the obstruction into an unusual area, such as the lower part of the trunk or the anterior abdominal wall, usually spurs the patient into action in terms of conducting diagnostic procedures so that diagnosis can be reached before complications occur. Defects of large magistral deep veins, which remain unrecognized until adulthood and which are diagnosed after complications in the drainage venous network occur, are infrequent. Complications that can arise in association with this malformation are manifested not only in varicosally altered collateral veins, but also in the venous drainage area peripherally from the obstruction. Case report: We hereby present a case of a patient admitted to hospital with a clinical picture and an ultrasound finding indicating an incarcerated inguinal hernia. During surgery, thrombophlebitis of extremely dilated prepubic veins was established. Subsequent diagnostic procedures revealed the presence of a rare vascular anomaly - aplasia of the left common and left external iliac veins. Under the mentioned conditions, a collateral venous network developed in both groins and the prepubic region, draining blood from the left leg into the right common femoral vein.