We present the case of a 46-year-old commercial pilot with a history of unilateral leg swelling following a flight to Geneva. Although initial clinical examination suggested a deep vein thrombosis, the swelling only partially resolved with anticoagulation and further imaging suggested the presence of adventitial cystic disease (ACD). The patient underwent initial anticoagulation to allow any thrombus to be lysed, followed by excision of the ACD from the venous wall and venous reconstruction. Following the excision of the ACD, providing the patient remains asymptomatic and further imaging finds normal venous anatomy, we hope the patient will discontinue anticoagulation and return to flying.
- Vascular surgery
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Contributors EH conducted the literature review for the case and made a significant contribution to writing the case report. RB made a significant contribution to the writing and editing of the case report and literature review. CD contributed significantly to collecting, interpreting and producing the radiological images and associated legends of the case. He also contributed to writing and editing the case report. BG initially consulted the patient in clinic and performed the excision of the adventitial cystic disease. He also contributed to the intraoperative findings and images provided in the report. He further contributed to the editing of the case report.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; externally peer reviewed.
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