A Complex Case of a Large Fibroid Uterus Compressing the Inferior Vena Cava Causing Recurrent Deep Vein Thrombosis and Pulmonary Embolisms.

Background: Uterine fibroids have been found to increase the risk for venous thromboembolism. There have been other case reports linking large uterine fibroids, pulmonary embolisms, and deep vein thrombosis (DVT) together due to compression of blood vessels and increased venous stasis. This case report will discuss a case of a large fibroid uterus compressing the inferior vena cava causing a patient with few risk factors to have recurrent DVTs and pulmonary embolisms.

Case presentation: The patient was a 35-year-old woman who presented with repeated unprovoked thrombosis episodes. The patient had a full workup after the first episode of DVT and was started on anticoagulation; however, the patient stopped taking her anticoagulation medication due to cost and presented to the emergency room 4 months later with a right lower extremity DVT and bilateral pulmonary embolisms.

Conclusion: There are many common causes that can explain recurrent thrombotic events in patients; however, it is important to also consider gynecological causes as a differential diagnosis when a patient presents with recurrent unexplained thrombotic events. Uterine fibroids that are large enough can compress large vessels and cause venous stasis in a relatively healthy person. Treating uterine fibroids can decrease the risk of another thrombotic event and can ultimately keep the patient off anticoagulation.