Renal vein thrombosis (RVT) and inferior vena cava thrombosis are extremely rare conditions, yet potentially life-threatening complications of pyelonephritis. This report describes the case of a 66-year-old patient with undiagnosed pyelonephritis, who subsequently developed RVT with an extension to the inferior vena cava. The management of the condition involved a multidisciplinary approach that resulted in nephrectomy with an extraction of the thrombus through cavotomy. This case report emphasizes the necessity of early recognition of RVT owing to pyelonephritis and complex management of this condition to prevent the adverse outcomes of impending complications.

Department of Surgery Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic

Department of Vascular Surgery University Hospital in Pilsen Pilsen Czech Republic

See more in PubMed

Asghar M., Ahmed K., Shah S.S., Siddique M.K., Dasgupta P., Khan M.S. Renal vein thrombosis. Eur J Vasc Endovasc Surg. 2007;34:217–223. doi: 10.1016/j.ejvs.2007.02.017. PubMed DOI

Lurz K.L., Hanna D.N., McGreen B.H., Schanne F.J. A rare case of renal vein thrombosis secondary to Klebsiella pneumoniae pyelonephritis. Urol Ann. 2018;10:103–105. doi: 10.4103/UA.UA_123_17. PubMed DOI PMC

Kounatidis D., Papadimitropoulos V., Vallianou N., et al. Renal vein thrombosis secondary to pyelonephritis: targeting a thrombo-inflammatory entity. Clin Pract. 2024;14:1110–1122. doi: 10.3390/clinpract14030088. PubMed DOI PMC

Yildiz H., Van Nieuwenhove S., Doyen M., Yombi J.C. Acute pyelonephritis and renal vein thrombosis: a case report and review of the literature. J Infect Chemother. 2016;22:759–761. doi: 10.1016/j.jiac.2016.04.009. PubMed DOI

Ben H.M., Ben Hadj Alouane H., Oueslati M.A., Fassi Fihri E.M., Chammakhi C., Ben Rhouma S. Segmental renal vein thrombosis: an unusual complication of acute pyelonephritis. Urol Case Rep. 2023;49 doi: 10.1016/j.eucr.2023.102444. PubMed DOI PMC

Wang I.K., Lee C.H., Yang B.Y., Chang H.Y., Lin C.L., Chuang F.R. Low-molecular-weight heparin successfully treating a nephrotic patient complicated by renal and ovarian vein thrombosis and pulmonary embolism. Int J Clin Pract Suppl. 2005;59:72–75. doi: 10.1111/j.1368-504x.2005.00342.x. PubMed DOI

Al-Katib S., Shetty M., Jafri S.M., Jafri S.Z. Radiologic assessment of native renal vasculature: a multimodality review. Radiographics. 2017;37:136–156. doi: 10.1148/rg.2017160060. PubMed DOI

Zhang L., Li C., Hua Z., et al. Comparative outcomes of anticoagulation alone versus anticoagulation plus endovascular intervention in adults with isolated renal vein thrombosis. J Vasc Surg Venous Lymphat Disord. 2023;11:816–823. doi: 10.1016/j.jvsv.2023.03.019. PubMed DOI

Srinivas B.C., Singh B., Srinivasa S., Reddy S.S., Mahadevappa N.C., Reddy B. Transcatheter pharmacomechanical approach for acute renal vein thrombosis: a rational technique. Cardiovasc Interv Ther. 2014;29:275–278. doi: 10.1007/s12928-013-0227-3. PubMed DOI

Baheti A., Sheeran D., Patrie J., Sabri S.S., Angle J.F., Wilkins L.R. Suprarenal inferior vena cava filter placement and retrieval: safety analysis. J Vasc Interv Radiol. 2020;31:231–235. doi: 10.1016/j.jvir.2019.08.012. PubMed DOI

Haidar G.M., Hicks T.D., El-Sayed H.F., Davies M.G. Treatment options and outcomes for caval thrombectomy and resection for renal cell carcinoma. J Vasc Surg Venous Lymphat Disord. 2017;5:430–436. doi: 10.1016/j.jvsv.2016.12.011. PubMed DOI