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Although there have been a few case reports of spontaneous rupture of pelvic veins, such as the iliac vein, to date, there have been no reports of spontaneous rupture of the ascending lumbar vein. Here, we report a case of spontaneous rupture of the ascending lumbar vein for the first time. A 66-year-old woman visited the emergency department due to the swelling of the left lower limb for 2 hours. After admission, the patient developed symptoms of pain in the left lumbar region, as well as symptoms of shock, such as increased heart rate and d