Unprovoked Extensive Deep Vein Thrombosis due to May-Thurner Syndrome in a Young Male

It is extremely uncommon for young adults to develop unprovoked deep venous thrombosis (DVT), the majority of the cases can be attributed to inherited thrombophilia; however, some rare cases test negative for thrombophilia, in these cases the most likely cause is an anatomic or congenital abnormality of the inferior vena cava or the iliac veins such as May-Thurner syndrome (MTS). MTS, an anatomic variant of the iliac vessels, described in 1957 by Dr. May and Dr. Thurner as the atypical positioning of the right common iliac artery over the left common iliac vein causing it to get obstructed. In this study, we report a rare case of a 36-year-old male that presented with acute left lower limb swelling, Investigations confirmed the presence of an unprovoked extensive left lower extremity DVT with bilateral MTS involving both the right and left common iliac veins. Hence, MTS and other vascular anomalies or variants must be considered in the differential diagnosis of unprovoked DVT in young adults.