45 Year old male doctor presents with breathlessness and fever, pulmonary angio revealed thromboembolism in segmental pulmonary arteries on right side. Bilateral lower limb doppler is negetive. Patient was obese to carryout abdominal doppler. MR angiogram thick MIP image shows partially occluding thrombus in the left renal vein extending partially in to IVC (arrow).
Although renal vein thrombosis (RVT) has numerous etiologies, it occurs most commonly in patients with nephrotic syndrome. The renal vein also may contain thrombus after invasion by renal cell cancer (Resources from Elsevier’s OncologySTAT). Other less common causes include renal transplantation, Behçet syndrome, hypercoagulable states, and antiphospholipid antibody syndrome.
Although colour doppler can pick up renal vein thrombosis, CT and MRI are better midalities for the diagnosis.