The Giant Intraabdominal Liposarcoma as a Cause of Chronic Intraabdominal Hypertension and Inferior Vena Cava Syndrome.

Aims: We report a case of development of chronic intraabdominal hypertension (IAH) in patient with giant abdominal liposarcoma and finally its presentation as inferior vena cava syndrome. Presentation of Case: A 77- year old patient presented with history of abdominal enlargement in last three years. The patient had dyspnea, legs edema and poorly tolerated supine position but he was without chest pain and complained on urinary frequency. CT scan of abdominal cavity shows huge tumor formation in front of abdominal cavity, and another one in pelvis, which compressed the bladder and spread into the inguinum. The patient had medical history of hypertension, chronic heart disease and chronic obstructive pulmonary disease (COPD). Discussion and Conclusion: This case report indicates complex pathophysiology of gradually increased intraabdominal pressure (IAP), which occurs in conditions like morbid obesity, big intraabdominal tumors, pregnancy and ascites development. Since the IAH increases gradually over months or years, the compensatory mechanisms adjust gradually as well, and thus reduce a possibility of acute IAH complications and ACS (abdominal compartment syndrome) development. In our case, patient was presented with symptoms of inferior vena cava syndrome (IVCS) as a result of external compression by a mass on the IVC. This case highlights the importance of understanding of pathophysiological events in chronic IAH as well as in acute IAH.

Endovascular treatment of inferior vena cava syndrome / 中国微创外科杂志

Objective To investigate the curative effect of endovascular treatment for inferior vena cava syndrome(IVCS).Methods A total of 17 cases of inferior vena cava syndrome was treated by endovascular dilatation and self-expandable metallic stent placement between June 2002 and November 2004.Routine anticoagulation therapy was given after the procedure.Results The pressure gradient across the inferior vena cava was reduced from 16.8?4.3 mmHg preoperatively to 2.6?0.6 mmHg postoperatively(t=13.280,P=0.001).The IVCS symptom scores were decreased from 4.4?1.6 preoperatively to 2.1?1.7 postoperatively(t=6.880,P=0.010).Symptoms of edema on lower limbs,scrotal or pubic dropsy,ascites,and anasarca subsided at 1～4 days after procedure.Conclusions Endovascular treatment of inferior vena cava syndrome is effective and reliable.