Calcific thrombi of the inferior vena cava in infants and children

Thrombosis of the Abdominal Veins in Childhood

Abdominal venous thrombosis is a rare form of venous thromboembolic disease in children. While mortality rates are low, a significant proportion of affected children may suffer long-term morbidity. Additionally, given the infrequency of these thrombi, there is lack of stringent research data and evidence-based treatment guidelines. Nonetheless, pediatric hematologists and other subspecialists are likely to encounter these problems in practice. This review is therefore intended to provide a useful guide on the clinical diagnosis and management of children with these rare forms of venous thromboembolic disease. Herein, we will thus appraise the current knowledge regarding major forms of abdominal venous thrombosis in children. The discussion will focus on the epidemiology, presentation, diagnosis, management, and outcomes of (1) inferior vena cava, (2) portal, (3) mesenteric, (4) hepatic, and (5) renal vein thrombosis.

Detection of tumor thrombus in children using color Doppler ultrasonography

Color Doppler ultrasonography (CDUS), which provides information regarding both the tissue and the blood flow simultaneously in real time, is a relatively new and noninvasive technique for the evaluation of organ perfusion. The authors investigated the usefulness of CDUS in the detection of tumor thrombus in 34 children who had malignant tumor (21 neuroblastomas, 2 Wilms' tumors, 5 hepatoblastomas, 2 rhabdomyosarcomas, and 4 others) who underwent CDUS between April 1992 and March 1995 in our department. The CDUS showed tumor thrombus in four patients (11.8%). Three thrombi (in one patient each with neuroblastoma, Wilms' tumor, and hepatoblastoma) were situated in the inferior vena cava, and one (in a patient who had hepatoblastoma) in the portal vein. Each tumor thrombus was monitored and followed up using CDUS every month during the entire clinical course; two of the four thrombi remained despite intensive treatments. The authors have found CDUS to afford rapid and noninvasive detection of tumor thrombus, and it proved useful not only in the detection of tumor thrombus but also in its follow-up in these children who had malignant tumor.

Neonatal renal venous thrombosis: sequential ultrasonic appearances

The ultrasonic appearances of three cases of renal venous thrombosis are shown. Initially the kidney is enlarged, echogenic and shows echogenic streaking that has a vascular or perivascular distribution. Subsequently thrombosis of renal veins or the inferior vena cava may be demonstrated and ultimately the kidney may recover or atrophy. The ultrasonic appearances will depend on the severity of the thrombosis and the stage at which the examination is performed.

Duplex Doppler ultrasound evaluation of calcified inferior vena cava thrombosis

We describe the use of duplex Doppler ultrasound in the noninvasive assessment of inferior vena cava patency and abdominal venous flow dynamics in a four month old infant with calcified inferior vena cava thrombosis.

Calcified thrombus of the inferior vena cava in transposition of the great vessels

Calcified thrombus of the inferior vena cava (IVC) in children is an entity usually not associated with significant complications. The possibility of pulmonary embolism from the soft thrombus, however, has been suggested but never reported. We give an account of a child with transposition of the great vessels who suffered embolization from a calcified thrombus in the IVC that entered the systemic circulation.

Computed tomographic diagnosis of calcified inferior vena cava thrombus in a child with Wilms' tumor

A calcified thrombus in the inferior vena cava of infants and children may be imaged by computed tomography. The precise location of the calcification within the inferior vena cava may be confirmed by computed tomographic scanning during injection of intravenous contrast material.