scholarly journals Unique Nutcracker Phenomenon Involving the Right Renal Artery and Portal Venous System

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Maximilian Stephens ◽  
Sarah Kate Ryan ◽  
Roger Livsey
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Vena Cava ◽  
The Body ◽  
External Compression ◽  
Portal Venous Phase ◽  
Nutcracker Phenomenon ◽  
Multiplanar Reconstructions ◽  
The Right

The nutcracker phenomenon is usually caused by compression of the left renal vein by the superior mesenteric artery anteriorly and the aorta posteriorly, although variations of this anatomy have previously been reported. We observed a nutcracker phenomenon in a 42-year-old female who underwent portal venous phase computed tomography of the body for oncologic workup. She had no documented proteinuria or hematuria. Multiplanar reconstructions demonstrated an enhancing left renal vein draining into the left ovarian vein without draining into the inferior vena cava due to external compression immediately before the renocaval junction. The left renal vein was compressed between the right renal artery and the portal vein. This type of nutcracker has not been previously reported in the literature and represents a new variation.

scholarly journals SURGICAL TREATMENT OF CHILDREN WITH NEUROBLASTOMA OF COMPLEX ANATOMICAL LOCALIZATION

2018 ◽  
Vol 22 (4) ◽  
pp. 172-178
Author(s):  
M. N. Sukhov ◽  
Sergey V. Sokolov ◽  
A. G. Narbutov ◽  
I. P. Lyvina ◽  
E. S. Andreev ◽  
...  
Keyword(s):  
Renal Artery ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Celiac Trunk ◽  
Left Renal Artery ◽  
Internal Organs ◽  
The Right ◽  
Large Vessels

Introduction. Neuroblastomas arise in the case of intimate association of the tumor with large vessels and internal organs. The early detailed stratification of cancer risk, as well as forecasting possible complications of surgery based on visual diagnostic methods, contribute to the improving the results in this category of patients. Material and methods. The study analyzes the results of the diagnosis and treatment of neuroblastoma of thoracoabdominal localization in 9 children aged from 9 to 55 months. All of them received the treatment according to the NB-2004 protocol. Before surgical intervention, the factors of the surgical risk were estimated from computed tomography with contrast, the number of factors averaged of 5. Results. The inclusion of the left renal artery and aorta into the tumor was revealed intraoperatively in 8 children, the involvement of the left renal vein, the right renal artery, the superior mesenteric artery was found in 7 patients, the right renal vein, the celiac trunk - in 6 cases, and the other large vessels - in a smaller number of cases. Damages of the right renal vein in 2 patients, left renal vein - in 2 children, aorta - in 1 child, inferior vena cava - in 2 observations and celiac trunk in 1 patient was sutured without subsequent complications. After injury and suturing of the inferior vena cava in a 1 patient, there was revealed a parietal thrombus without clinically significant hemodynamic disturbances. In 1 observation, postoperative thrombosis of the left renal artery caused the deterioration of the blood flow requiring nephrectomy. Damage to the pancreas in 1 child was accompanied by a long drainage and the formation of pancreatojejunostomy. The volume of the resection of the tumor amounted on average of 93%. The total number of complications in the early postoperative period accounted for 44%, out of which repeated surgical interventions were required in case of bleeding against the therapy of renal artery thrombosis in 1 patient and focal pancreatic necrosis in the 1 patient. The duration of postoperative follow-up was of 18 months. Overall survival is 100%, the event-free survival rate is of 78%. The continued growth of the tumor was registered in 2 patients in the high-risk group. Discussion. Neoadjuvant chemotherapy contributed to the enhancement of the radicalization of the surgical treatment, leading to a decrease in the size of the primary focus, metastases, and involvement of large vessels and internal organs in the tumor. The radical removal of neuroblastoma is acceptable in the absence of the invasive growth in the walls of large vessels and internal organs, otherwise, the resection should be performed for the purpose of cytoreduction and prevention of organ failure due to tumor compression.

scholarly journals Anatomical study of the renal veins observed during 342 living-donor nephrectomies

1997 ◽  
Vol 115 (3) ◽  
pp. 1456-1459 ◽  
Author(s):  
José Carlos Costa Baptista-Silva ◽  
Marcos José Veríssimo ◽  
Marcos Joaquim Castro ◽  
André Luiz Guimarães Câmara ◽  
José Osmar Medina Pestana
Keyword(s):  
Renal Vein ◽  
Living Donor ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Renal Veins ◽  
Gonadal Vein ◽  
The Right

The anatomical variations of renal veins observed during 342 nephrectomies in living donors are described, 311 cases on the left side and 31 on the right. The following anatomy of the renocava veins was observed: 1. On the left side the renal vein was always unique (311/311) and had two tributaries (suprarenal and gonadal veins) in 100 per cent and one or more renolumbar veins in 65.27 per cent, encircling the aorta in 1.07 per cent, was retroaortic in 1.4 per cent; and the inferior vena cava was double in 0.64 per cent; B- on the right side the renal vein was double in 29 per cent (9/31) and had only one tributary (gonadal vein) in one case, for 3.22 per cent (1/ 31); three or more renal veins in 9.7 per cent (3/31). We concluded that the left renal vein is always unique, presenting variations principally in its tributaries and trajectory. On the right side, the renal vein was double or triple in 38.79 per cent

scholarly journals Inverted Nutcracker Syndrome: A Case of Persistent Hematuria and Pain in the Presence of a Left-Sided Inferior Vena Cava

2011 ◽  
Vol 11 ◽  
pp. 1031-1035 ◽  
Author(s):  
Obi Ekwenna ◽  
Michael A. Gorin ◽  
Miguel Castellan ◽  
Victor Casillas ◽  
Gaetano Ciancio
Keyword(s):  
Inferior Vena Cava ◽  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
The Right

Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.

scholarly journals A cadaveric study of anatomical variations of testicular veins

2018 ◽  
Vol 7 (03) ◽  
pp. 139-140
Author(s):  
Anly Antony ◽  
J. Sujitha Jacinth
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Lateral Wall ◽  
Public Health Issue ◽  
Text Book ◽  
South Indian ◽  
The Right

Abstract Background: Infertility is considered a major public health issue. A multicentric WHO study showed increased frequency of varicocele in infertile couples to vary geographically from 6% to 47%. Some theorize, varicocele results due to anatomical differences between the right and left testicular veins. This disparity is believed, leads to increase in hydrostatic pressure of the left testicular vein, which is subsequently transferred to the venous plexus, causing dilation. Hence knowledge of testicular venous pattern and its variations takes paramount importance. Aims: To study anatomy of testicular veins with focus on: a] normal and occurrence of varying number and patterns of testicular veins b] to find explanations for incidence of some anomalies c] to consider surgical significance of such variations and d] to compare the results of the present study with previous studies. Materials and methods: The study material comprised of 25 embalmed, adult human male cadavers of south Indian origin. Systematic dissection was carried out following the guidelines of Cunninghairr s Manual of Practical Anatomy. Results: On five sides, four testicular veins were found at the deep inguinal ring. On the left side, all testicular veins terminated in the left renal vein with some showing duplication. Variations in the terminations of testicular veins were seen in three of the right sides, which included termination in the right renal vein, junction of the inferior vena cava with the right renal vein and in one case following duplication, veins terminated on the anterior and lateral wall of the inferior vena cava. Conclusion: Termination of testicular veins followed standard text book pattern on the left side, however a slight increase in the duplication of veins was observed on this side. On the right side, testicular veins showed variations in the site of termination and also duplication. Knowledge of these findings can be of importance in clinical practice related to the problems of the testis.

Unusual Drainage of the Bifurcated Left Renal Vein Into a Dilated Lumbar Azygos Vein and Inferior Vena Cava

2019 ◽  
Vol 53 (7) ◽  
pp. 585-588
Author(s):  
Ewa J. Bialek ◽  
Bogdan Malkowski
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Azygos Vein ◽  
Positron Emission ◽  
Points Of View ◽  
The Right ◽  
Pelvic Congestion

We report a unique case of unusual drainage of the bifurcated retroaortic left renal vein, with the cranial wider branch draining into a dilated lumbar azygos vein and caudal thinner branch connecting with the inferior vena cava. The right renal vein was duplicated. The anomaly was discovered on multimodal 18F-labeled fluorodeoxyglucose positron emission tomography/computed tomography performed for oncological purposes. The basis enabling occurrence of such variation was probably persistent developmental extra left–right venous connections, intercardinal, or intersupracardinal, depending on the theory. The embryology of the chest and abdominal veins is a complicated process and there is no unanimity concerning its concepts. The old models are currently being questioned and reevaluated. Knowledge of possible variants of renal and azygos veins course is important from clinical, imaging, and surgical points of view. The retroaortic left renal veins course may sometimes cause pain, hematuria, proteinuria, and pelvic congestion syndromes. Dilated parts of uncommonly located veins, because of assuming a nodular shape on transverse images, may be mistaken for abnormal lymph nodes, other tumors or aneurysms on imaging. During a variety of surgical procedures, including venous sampling, renal transplantation, or any retroperitoneal surgery, knowledge of an aberrant venous course may be important for the success of the procedure and may be crucial even earlier during the qualification process.

scholarly journals Embryological and surgical considerations of absent infra-renal part of inferior venacava and left renal vein

2020 ◽  
Vol 11 (5) ◽  
pp. 83-86
Author(s):  
Indira CK ◽  
Arunkumar KG
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Femoral Vein ◽  
Left Renal Vein ◽  
Abdominal Cavity ◽  
Vena Cava ◽  
Complex Process ◽  
Long Course ◽  
The Right

Background: Development of inferior vena cava (IVC) is a complex process that involves the anastomoses between three pairs of embryonic veins. Specific permutations exist in the venous plane of the abdomen and pelvis resulting in variations such as single left IVC, double IVC, and left renal retroaortic vein. Anomalies of the inferior vena cava and renal veins occur infrequently but may contribute to serious morbidity throughout surgical exploration if unidentified. Most anomalies remain asymptomatic until surgical intervention or clinical presentation with thromboembolic complications. Aims and Objective: Our research is aimed to link embryology with developmental disorder and the complications associated with the anomalous vessels in the field of surgery. Materials and Methods: Ten IUD fetuses (ranging from 20 weeks to term fetuses) were collected from the O&G department of the college and injected locally with dilute formalin and placed in containers filled with formalin. Dissection of the fetuses was done to identify congenital anomalies. Results: The external appearance of the 28-week-old fetus showed no gross anomaly. Examination abdominal cavity showed absent infrarenal segment of IVC and left renal vein. The right renal vein was seen running a long course to the left side with tributaries of lumbar veins and was seen continuing as the left femoral vein medial to the femoral artery. Segments of suprarenal and renal IVC were present. Conclusion: Correlating anomalies and variations of IVC and its tributaries to embryology. However, understanding of such anomaly is necessary to avoid significant diagnostic pitfalls and in preoperative surgicaland radiological intervention planning.

Previous vena cava occlusion as the cause of a bilateral iliofemoral thrombosis

Phlebologie ◽  
2016 ◽  
Vol 45 (05) ◽  
pp. 322-324
Author(s):  
B. Burkert ◽  
Ph. Regeniter ◽  
A. Mumme ◽  
T. Hummel ◽  
D. Mühlberger
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Inferior Vena Cava Occlusion ◽  
Computed Tomography Scanning ◽  
Iliofemoral Thrombosis ◽  
The Right

SummaryA case of bilateral iliofemoral thrombosis in a 17-year-old [male] patient is presented. It was only revealed during bilateral transfemoral thrombectomy that the thrombosis was due to previous inferior vena cava occlusion. This required a complex interventional reconstruction of the vena cava with secondary stenting of both renal veins. The postoperative venogram showed blood outflow from the left renal vein into the portal vein and from the right renal vein into the inferior vena cava via collaterals. At follow-up presentation, the patient was asymptomatic with normal findings on computed tomography scanning.

The Coagulation System during the Passage of Blood through the Body

1969 ◽  
Vol 22 (02) ◽  
pp. 326-335
Author(s):  
KL Schimpf ◽  
P Barth ◽  
J Bartman ◽  
J Freienberg ◽  
B Hansen ◽  
...  
Keyword(s):  
Renal Vein ◽  
Vena Cava ◽  
The Body ◽  
Coagulation System ◽  
Thrombin Time ◽  
Contact Activation ◽  
Right Heart ◽  
The One ◽  
The Right ◽  
Vena Portae

SummaryIn rabbits blood was taken simultaneously from the right heart, aorta, vena cava caudalis, and vena portae. The samples were examined for activities of factors II, VIII, X, contact activation product, antithrombin III, anti-plasma-thromboplastin, for thrombin time, fibrin polymerization time, R+K values in the TEG and platelet count. The parameters were found to change significantly during circulation. The greatest differences were found between right heart on the one hand, and renal vein and portal vein on the other. In 8 of 10 cases the arithmitical means of the tested parameters showed highest or lowest values respectively in the renal vein.

scholarly journals Inferior Vena Cava Duplication: Incidental Case in a Young Woman

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Danilo Coco ◽  
Sara Cecchini ◽  
Silvana Leanza ◽  
Massimo Viola ◽  
Stefano Ricci ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Renal Vein ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Vena Cava ◽  
Surgical Interventions ◽  
Azygos Continuation ◽  
Vascular Structures ◽  
Double Inferior Vena Cava ◽  
The Right

A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures.

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