Vascular
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Aneurysms of the inferior vena cava (IVC) are exceedingly rare; less than 50 cases have been reported in the world literature. Owing to the paucity of data regarding the natural history of IVC aneurysms, there is no consensus on their treatment. This case report describes the evaluation of an IVC aneurysm in a 56-year-old male, briefly discusses the embryologic development of the IVC, and revisits the question of whether surgical intervention is indicated in these patients.
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Case Reports
Klippel-Trénaunay syndrome: treatment of lower extremity pain with a spinal cord stimulator.
A young adult man with Klippel-Trénaunay syndrome presented to our pain management service with complaints of severe lower extremity neuropathic pain (pain scale 8 of 10 on the left and 4 of 10 on the right). The pain in his left leg was so severe that he wanted to undergo a left lower extremity amputation. The patient declined chronic use of narcotic medications for pain relief, believing that this would interfere with his educational and lifestyle pursuits. ⋯ At 1 year postimplantation, he was pain free (pain scale 1 of 10 bilaterally) and was able to function normally without narcotic support. We believe this to be the first use of a spinal cord stimulator for lower extremity pain resulting from Klippel-Trénaunay syndrome. We also discuss the clinical evaluation and treatment of a Klippel-Trénaunay syndrome patient with chronic pain.