Introduction: Venous thromboembolism represents a potential serious condition that affects the venous system by forming clots. There are two types of venous thromboembolism: deep venous thrombosis (DVT), which is a clot in a deep vein, usually in leg, but sometimes in the arm or other veins and pulmonary embolism (PE) that occurs when a clot blocks some of blood supply in lungs.
Case presentation: We would like to present a case of male patient of 40 years old, ex-smoker, known with hydrostatic varicose veins in legs, with recurrent deep venous thrombosis on popliteal and tibial veins, with hypoplasia of inferior vena cava under hepatic veins, hypoplasia of right iliac venous axis, with chronic venous insufficiency with ulcers of the calf, and with bla-dder neoplasma with radiotherapy and chemotherapy, in chronic treatment with Rivaroxaban, who was ad-mitted at emergency room of the Emergency Military Hospital in Bucharest accusing severe localized pain on the right tie which was swollen and presented all the inflammatory characteristics, cough, dyspnea of rest and chest pain. We performed Doppler venous ultrasound that identified right iliac venous thrombosis, and the pulmonary CT-scan showed bilateral pulmonary embolism, even if the patient had oral anticoagulant therapy in which the patient is compliant.
Conclusions: From this case is important to draw the conclusion that in a patient with a lot of comorbidities – bladder neoplasm, important congenital anomalies of the vascular system, with recurrent deep vein throm-bosis, the risk of venous thrombosis is increased even with oral anticoagulant therapy.