Deep venous thrombosis and pulmonary thromboembolism associated with a huge uterine myoma - A case report

A 51-year-old woman with a large uterine myoma suffered from acute pulmonar y thromboembolism. Venography revealed thrombosis in the right common iliac vein and almost complete obstruction of the left common iliac vein. The as cending lumbar vein showed collateral drainage. Treatment was initiated wit h continuous intravenous heparin sodium, and a Greenfield filter was insert ed to prevent the extension of the pulmonary embolism during and after hyst erectomy. After a total hysterectomy, venography revealed restoration of pa tency in the bilateral common iliac veins, and no flow was seen in the asce nding lumbar vein. Thorough clinical examinations failed to identify any ot her prothrombotic conditions. These results suggest that a large uterine my oma compressed veins in the pelvis, and the resulting impaired blood flow c aused deep venous thrombosis and pulmonary thromboembolism.