DVT vs May-Thurner syndrome

Q: 32 years old female is admitted to ICU with acute pain and swelling of the entire unilateral lower extremity. There is a concern for Deep Venous Thrombosis (DVT) vs "May-Thurner syndrome." Acute pain and swelling of which entire lower extremity favors the diagnosis of May-Thurner syndrome? - select one

A) Right

B) Left

Answer: B

The classic presentation of May-Thurner syndrome is the acute pain and swelling of the entire left lower extremity. It occurs mostly in females in the second or third decade. It occurs due to the compression of the left iliac vein between the overlying right common iliac artery and the fifth lumbar vertebrae. Said that May-Thurner syndrome may occur with or without venous thrombosis. 

This differential diagnosis is important as the management approach may differ entirely.

#vascular-surgery

#surgical-crtical-care

References:

1. Mousa AY, AbuRahma AF. May-Thurner syndrome: update and review. Ann Vasc Surg. 2013 Oct;27(7):984-95. doi: 10.1016/j.avsg.2013.05.001. Epub 2013 Jul 10. PMID: 23850314.

2. Al Sinani A, Al Saadi W, Al Harthi S, Al Hajriy M. May-Thurner Syndrome: A Case Report and a Concise Review. Cureus. 2021 Jul 8;13(7):e16256. doi: 10.7759/cureus.16256. PMID: 34373817; PMCID: PMC8346263.