Deep venous thrombosis after varicocele surgery as a clinical manifestation of inferior vena cava agenisis

Introduction: About 2% of the general population show anomalies of the inferior vena cava. These malformations usually have no clinical significance and are diagnosed incidentally. Case Report: We report on a case of deep vein thrombosis after surgical management of right-sides varicocele following ligation of a left-sided varicocele 3 years ago. Diagnostic evaluation of the thrombosis revealed an absent lower part of the inferior vena cava as well as blind ending iliac veins. In retrospect, the bilateral varicoceles have to be interpreted as collaterals compensating for a congenitally absent inferior vena cava. Conclusions: In the rare case of right-sided or bilateral varicoceles (Grade II-III) we therefore recommend use of duplex-ultrasonography to exclude such underlying vascular malformations.