[Diagnostic error of thrombosis of the inferior vena cava with contrast-CT in tricuspid valve insufficiency].

Abstract

Sonographic evidence of a cystic adrenal tumour was found in a 73-year-old female patient with a 6-month history of chest pain and dyspnoea. A computed tomogram of the abdomen revealed, in addition to the 5-cm lesion, a contrast medium-free area in the vena cava inferior, leading to an initial diagnosis of recurrent pulmonary emboli due to a thrombosis of the vena cava inferior. Further diagnostic procedures excluded emboli and indicated a dilating cardiomyopathy with mitral and tricuspid regurgitation. The contrast medium-free area in the vena cava inferior was caused by the influx and regurgitation of contrast medium-free blood from the renal and hepatic veins in addition to blood from the right atrium due to the tricuspid valve regurgitation. A thrombosis was excluded by means of a color-duplex investigation. The patient declined any further diagnostic procedures concerning the lesion.