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Ruptures can also occur spontaneously due to veins being overstretched as a result of excess pressure because of obesity or high blood pressure, or some other condition that cause the vein cell structure to weaken to the extent that the vein walls fail.
The most common cause of pelvic vein obstruction is compression of the iliac vein in the pelvis as it carries blood flow out of the leg and pelvis. Iliac vein compression often occurs because the iliac vain is squeezed between the iliac artery and the spine.