Published online Nov 27, 2018. doi: 10.4254/wjh.v10.i11.887
Peer-review started: June 4, 2018
First decision: July 10, 2018
Revised: August 15, 2018
Accepted: October 10, 2018
Article in press: October 10, 2018
Published online: November 27, 2018
Processing time: 176 Days and 20.4 Hours
Abdominal pain with elevated transaminases from inferior vena cava (IVC) obstruction is a relatively common reason for referral and further workup by a hepatologist. The differential for the cause of IVC obstruction is extensive, and the most common etiologies include clotting disorders or recent trauma. In some situations the common etiologies have been ruled out, and the underlying process for the patient’s symptoms is still not explained. We present one unique case of abdominal pain and hepatomegaly secondary to IVC constriction from extrinsic compression of the diaphragm. Based on this patient’s presentation, we urge that physicians be cognizant of the IVC diameter and consider extrinsic compression as a contributor to the patient’s symptoms. If IVC compression from the diaphragm is confirmed, early referral to vascular surgery is strongly advised for further surgical intervention.
Core tip: Common etiologies of abdominal pain with elevated transaminases are clotting disorders and trauma. In this article, we present a rare case of external compression of the diaphragm as the cause of these symptoms that requires surgical intervention to relieve the obstruction.