Grandhe S, Lee JA, Chandra A, Marsh C, Frenette CT. Trapped vessel of abdominal pain with hepatomegaly: A case report. World J Hepatol 2018; 10(11): 887-891 [PMID: 30533189 DOI: 10.4254/wjh.v10.i11.887]
Corresponding Author of This Article
Catherine T Frenette, MD, Academic Research, Attending Doctor, Doctor, Scripps Center for Organ Transplant, Scripps Green Hospital, 10666 North Torrey Pines Road, La Jolla, CA 92037, United States. frenette.catherine@scrippshealth.org
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Nov 27, 2018; 10(11): 887-891 Published online Nov 27, 2018. doi: 10.4254/wjh.v10.i11.887
Trapped vessel of abdominal pain with hepatomegaly: A case report
Sirisha Grandhe, Joy A Lee, Ankur Chandra, Christopher Marsh, Catherine T Frenette
Sirisha Grandhe, Department of Gastroenterology and Hepatology, University of California Davis Medical Center, Sacramento, CA 95817, United States
Joy A Lee, Department of Internal Medicine, Scripps Green Hospital, La Jolla, CA 92037, United States
Ankur Chandra, Department of Vascular Surgery, Scripps Green Hospital, La Jolla, CA 92037, United States
Christopher Marsh, Catherine T Frenette, Scripps Center for Organ Transplant, Scripps Green Hospital, La Jolla, CA 92037, United States
Author contributions: Grandhe S and Lee JA designed and wrote the report; Chandra A collected the patient’s data and contributed the images; Marsh C and Frenette CT collected the patient’s clinical data and edited the paper.
Informed consent statement: The patient agreed to allow her case to be published including any relevant laboratory data and images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Catherine T Frenette, MD, Academic Research, Attending Doctor, Doctor, Scripps Center for Organ Transplant, Scripps Green Hospital, 10666 North Torrey Pines Road, La Jolla, CA 92037, United States. frenette.catherine@scrippshealth.org
Telephone: +1-858-5544310
Received: June 4, 2018 Peer-review started: June 4, 2018 First decision: July 10, 2018 Revised: August 15, 2018 Accepted: October 10, 2018 Article in press: October 10, 2018 Published online: November 27, 2018
Abstract
Abdominal pain with elevated transaminases from inferior vena cava (IVC) obstruction is a relatively common reason for referral and further workup by a hepatologist. The differential for the cause of IVC obstruction is extensive, and the most common etiologies include clotting disorders or recent trauma. In some situations the common etiologies have been ruled out, and the underlying process for the patient’s symptoms is still not explained. We present one unique case of abdominal pain and hepatomegaly secondary to IVC constriction from extrinsic compression of the diaphragm. Based on this patient’s presentation, we urge that physicians be cognizant of the IVC diameter and consider extrinsic compression as a contributor to the patient’s symptoms. If IVC compression from the diaphragm is confirmed, early referral to vascular surgery is strongly advised for further surgical intervention.
Core tip: Common etiologies of abdominal pain with elevated transaminases are clotting disorders and trauma. In this article, we present a rare case of external compression of the diaphragm as the cause of these symptoms that requires surgical intervention to relieve the obstruction.
