Abstract
A bullet thrombus, characterized as an isolated calcified thrombus predominantly localized at the confluence of the renal veins in the inferior vena cava, is a rare clinical finding more commonly seen in pediatric patients than adults. The aetiology of bullet thrombi remains unclear. This report describes a 44-year-old female diagnosed with a bullet thrombus in the inferior vena cava, detailing the challenges encountered and the surgical intervention. The presence of a calcified thrombus in this region is typically an incidental discovery and complicates therapeutic decision-making, as there are currently no established guidelines due to the condition's rarity.