Compounded Challenges in Managing May-Thurner Syndrome with Concurrent Severe Obesity: A Case Study on Complex Deep Vein Thrombosis in a Young Male
Keywords:
May-Thurner Syndrome; Deep Vein Thrombosis; Iliac Vein Compression; Obesity; Venous Thromboembolism; Case Report.Abstract
Background: May-Thurner Syndrome (MTS) is a rare vascular disorder resulting from compression of the left common iliac vein by the overlying right common iliac artery. This anatomical variant predisposes patients to deep vein thrombosis (DVT), most commonly affecting the left lower extremity. Early recognition is crucial, as undiagnosed MTS can lead to recurrent thrombosis and long-term venous complications.
Case Presentation: We report a case of a 20-year-old male with severe obesity (body weight 145 kg) who presented with acute pain and swelling of the left lower limb. Duplex ultrasound revealed extensive thrombosis of the left lower extremity veins. Computed tomography (CT) venography demonstrated compression of the left common iliac vein by the right common iliac artery, confirming the diagnosis of MTS.
Management and Outcome: The patient was managed with anticoagulation therapy to treat the acute thrombotic event. A multidisciplinary team involving vascular medicine and interventional radiology evaluated options for addressing the underlying venous compression. The patient showed clinical improvement with symptom resolution and no evidence of recurrent thrombosis on follow-up.
Conclusion: This case highlights the importance of considering MTS in young patients presenting with unexplained left-sided DVT, particularly in the presence of risk factors such as obesity. Timely diagnosis through appropriate imaging and multidisciplinary management can prevent serious complications and improve long-term outcomes.
