scholarly journals Navigation and design of adrenal surgery with the aid of computed tomography

2021 ◽  
Vol 23 (3) ◽  
pp. 41-48
Author(s):  
Sofya G. Blyumina ◽  
Pavel N. Romashchenko ◽  
Igor S. Zheleznyak
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Adrenal Glands ◽  
Inferior Vena ◽  
Left Kidney ◽  
Operating Time ◽  
Vena Cava ◽  
Central Vein ◽  
Number Of Patients ◽  
The Right

This study evaluated the possibilities of designing a safe access for adrenalectomy using preoperative computed tomography navigation. The outcomes of surgical interventions in 1.457 patients with diseases of the adrenal glands requiring surgery were examined, among which 1.209 patients underwent endovideosurgery with a follow-up period of up to 20 years. Of the total number of patients, 418 were included in the analysis for the preoperative design of access for adrenalectomy using computed tomography navigation. This cohort was conditionally divided into a retrospective group (n = 157) and a prospective group (n = 261). After a comprehensive examination of patients with adrenal formations, according to the algorithm developed at the department, an integral assessment of the leading anthropometric (body mass index and physique form) and computed tomography criteria (i.e., formation diameter; tumor synthopia with respect to the walls of the inferior vena cava; length of the central adrenal vein and the place of its confluence with the lower hollow and renal veins; location of the tumor relative to the lower vein of the right lobe of the liver, as well as relative to the gate of the right kidney; location near the aortorenal vascular triangle; gate of the left kidney; and spleen vessels) allows us to justify the selection of a rational technique and the volume of the surgical treatment. Among endovideosurgical interventions, adrenalectomy from a retroperitoneoscopic access has a significant advantage because it causes the least trauma and short operating time in comparison with laparoscopic access. No intraoperative complications occurred, taking into account the planning of the access option and technique for performing adrenalectomy. Expected complications that may have occurred during adrenalectomy were damage to the central vein of the adrenal glands, renal and spleen vessels, and inferior vena cava and intraoperative blood loss. In general, an increase in operating time directly depends on the peculiarities of the location of the tumor in the adrenal gland, which can be evaluated in detail using preoperative computed tomography, making it possible to reasonably use endovideosurgical or open adrenalectomy alternatives and thus reliably improving the immediate treatment outcomes of the patients.

scholarly journals METHOD FOR DESIGNING SURGICAL ACCESS FOR ADRENALECTOMY USING 3D-MODELING

2020 ◽  
Vol 23 (2) ◽  
pp. 165-171
Author(s):  
P. N. Romashchenko ◽  
I. S. Zheleznyak ◽  
N. A. Maistrenko ◽  
S. G. Bliumina
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Left Kidney ◽  
Three Dimensional ◽  
Vena Cava ◽  
Vascular Complications ◽  
Risk Criteria ◽  
Surgical Access ◽  
Preoperative Ct ◽  
The Right

In the literature, insufficient attention is paid to the preoperative planning of the approach to adrenal glands using the modern capabilities of computed tomography (CT) navigation. The aim of the work was to demonstrate the possibilities of designing safe access for adrenalectomy using three-dimensional printed models based on preoperative CT data. The possibilities of preoperative access design for edrenalectomy were studied in 362 adrenal tumor patients who underwent CT imaging on Aquillion 64 (Toshiba, Japan), followed by post-processor image processing, construction of multi-plane and 3D reconstructions. All patients were divided into retrospective (n=157) and prospective (n=205) groups. In 3 clinical cases, preoperative access design was supplemented by the creation of a three-dimensional printed model of the adrenal gland with a tumor using the Slicer 4.10.1 software. Reliable anthropometric (body mass index, body shape) and CT-criteria for designing surgical access to the left and right adrenals were determined: diameter of formation; tumor syntopy in relation to the walls of the inferior vena cava; the length of the central adrenal vein and the place where it flows into the inferior vena cava; the location of the tumor relative to the inferior vein of the right lobe of the liver, as well as relative to the gate of the right kidney; location near the aortic-renal vascular triangle, gate of the left kidney and spleen vessels. Three patients with a borderline number of risk criteria for the development of vascular complications associated with the technical difficulties of adrenalectomy (for right adrenals≥4, for left adrenals≥3) underwent CT-segmentation of images with the subsequent creation of three-dimensional plates - a model of an NP tumor with neighboring organs and vessels. Preoperative CT design of the approach, taking into account the risk criteria for complications and the use of 3-D printed models, can reasonably apply endoscopic and open options for adrenalectomy, significantly improving the immediate results of treatment of patients.

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 Incidental right Bochdalek hernia with interruption of the inferior vena cava and hepatic venous collateral continuation: A case report

2014 ◽  
Vol 18 (1) ◽  
Author(s):  
Farzanah I. Ismail ◽  
Rule Human ◽  
Anith Chacko ◽  
Parmanand Naran ◽  
Samia Ahmad ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Case Report ◽  
Pulmonary Tuberculosis ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Employee Wellness ◽  
Bochdalek Hernia ◽  
The Right ◽  
Routine Chest

A 36-year-old asymptomatic female had a routine chest radiograph to exclude pulmonary tuberculosis, as part of an employee wellness programme. There was opacification of the right lower thorax. Computed tomography and venography demonstrated an incidental right Bochdalek hernia with interruption of the inferior vena cava (IVC) and hepatic venous collateral continuation. The association of a Bochdalek hernia with an anomaly of the IVC is rare, with only one case described in the literature.

scholarly journals Clinical Insight into the Precaval Right Renal Artery: A Multidetector Row Computed Tomography Angiographic Study

ISRN Anatomy ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Shubha Srivastava ◽  
Indra Kumar ◽  
C. S. Ramesh Babu ◽  
K. K. Gupta ◽  
O. P. Gupta
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Minimally Invasive ◽  
Renal Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Multidetector Row Computed Tomography ◽  
Renal Vasculature ◽  
Multidetector Row ◽  
The Right

Variations of course and number of renal vessels are not so uncommon and their knowledge is important for planning of minimally invasive renal surgeries. The earlier literature reports a prevalence of precaval right renal artery between 0.8% and 5%. Normally, the right renal artery passes posterior to the inferior vena cava, but it can also be precaval where it passes anterior to inferior vena cava. The multidetector row contrast enhanced computed tomography angiography allows precise evaluation of renal vasculature. The aim of this retrospective study is to determine the prevalence of precaval right renal artery. Amongst 73 MDCT scans studied, we identified 4 cases of precaval right renal artery with the prevalence being 5.48%, more than what is reported in the earlier literature. We also report a single and dominant precaval right renal artery in one of the cases, which is a rare finding. On the basis of these results, we conclude that precaval right renal artery appears to be more common and so the knowledge of this variant holds a major clinical implication in preventing misinterpretation of radiological images and proper planning of interventional procedures and minimally invasive surgeries.

scholarly journals Planning of the Autotransplantation of the Liver to the Patients with Advanced Alveococosis Based on the Multidetector Computed Tomography

2017 ◽  
pp. 123-131 ◽  
Author(s):  
A. N. Bashkov ◽  
S. E. Voskanyan ◽  
Z. V. Sheykh ◽  
G. G. Karmazanovsky ◽  
A. P. Dunaev ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Inferior Vena Cava ◽  
Multidetector Computed Tomography ◽  
Inferior Vena ◽  
Vena Cava ◽  
Pathological Process ◽  
Hepatic Veins ◽  
Portal Veins ◽  
Scan Data ◽  
The Right

Aim: to analize computed tomography data while planning autotransplantation of the liver for advanced alveococcosis.Materials and Methods.A retrospective analysis of the results of multidetector computed tomography of the abdomen and retroperitoneal space of 7 patients with advanced liver alveococcosis was made in order to plan autotransplantation. Besides a description of the location and size of parasitic lesion for each patient relationship with main vessels was evaluated - the inferior vena cava, hepatic and portal veins, hepatic arteries, and the presence of extrahepatic component. The vessel assessed as involved in the pathological process not only in case of clear invasion, but also with abutment because of infiltrative growth of alveococcus. The accuracy of the method was estimated by comparison with the intraoperative data.Results.The data of computed tomography while the planning of liver autotransplantation coincided with the intraoperative data in all examined patients. The main criteria indicating the need for this type of surgical intervention was the involvement of the retrohepatic part of the inferior vena cava to the caval gates inclusive and/or hepatic veins. With extrahepatic spread of parasitic masses it is possible to affect not only the surrounding organs, but also the main vessels, for example, with growth in the hepatic-duodenal ligament. Thus, in one patient during the operation, the occlusion of artery hepatica propria was confirmed. In two cases of recurrence of the parasitic process after rightsided hemihepatectomy, the almost identical pattern of involvement of the liver resection surface, inferior cava and portal veins, diaphragm, adrenal gland in combination with a extent adhesive process in the right subdiaphragmal space.Conclusions.CT scan data allowed to correctly plan the volume of operative intervention – autotransplantation of the liver – in all the examined patients. It is of interest to evaluate the accuracy of the method on a larger group of patients.

Surgery of left kidney cancer with tumour thrombus formation in the inferior vena cava and the right heart

2016 ◽  
Vol 4 (4) ◽  
pp. 45-49
Author(s):  
A.V. Kondrashina ◽  
◽  
R.N. Komarov ◽  
E.A. Bezrukov ◽  
S.V. Chernyavskiy ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Kidney Cancer ◽  
Inferior Vena ◽  
Thrombus Formation ◽  
Left Kidney ◽  
Vena Cava ◽  
Right Heart ◽  
Tumour Thrombus ◽  
The Right

scholarly journals Emphysematous pyelonephritis with air bubble in the inferior vena cava

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Tiffany A. Perkins ◽  
Alberic Rogman ◽  
Murali K. Ankem
Keyword(s):  
Septic Shock ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Rare Presentation ◽  
Emphysematous Pyelonephritis ◽  
Case Presentation ◽  
Air Bubble ◽  
First Case ◽  
The Right

Abstract Background Emphysematous pyelonephritis (EPN) with gas in the inferior vena cava (IVC) is a rare presentation and to our knowledge, this is the first case report in the urologic literature. Case presentation A 35-Year-old obese diabetic Hispanic female presented to the emergency room with a clinical picture of septic shock. Prompt computerized tomography scan revealed EPN with gas throughout the right renal parenchyma and extending to the right renal vein, IVC, and pulmonary artery. She died before surgical intervention Conclusion This case demonstrates that patients presenting with severe EPN have a high mortality risk and providers should acknowledge that septic shock, endogenous air emboli, or a combination of both could result in cardiovascular collapse and sudden death.

Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome

2021 ◽  
pp. 153857442110020
Author(s):  
Reza Talaie ◽  
Hamed Jalaeian ◽  
Nassir Rostambeigi ◽  
Anthony Spano ◽  
Jafar Golzarian
Keyword(s):  
Inferior Vena Cava ◽  
Transjugular Intrahepatic Portosystemic Shunt ◽  
Inferior Vena ◽  
Vena Cava ◽  
Portosystemic Shunt ◽  
Hepatic Veins ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Intrahepatic Portosystemic Shunt ◽  
The Right

Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.

Stent Graft Placement in the Top-Down Direction for Treating Traumatic Intra-Abdominal Suprahepatic Inferior Vena Cava Rupture: A Case Report

2021 ◽  
pp. 152660282110250
Author(s):  
Yun Chul Park ◽  
Hyoung Ook Kim ◽  
Nam Yeol Yim ◽  
Byung Chan Lee ◽  
Chan Park ◽  
...  
Keyword(s):  
Case Report ◽  
Inferior Vena Cava ◽  
Stent Graft ◽  
Inferior Vena ◽  
Vena Cava ◽  
Endovascular Management ◽  
Top Down ◽  
Life Threatening ◽  
The Right ◽  
Suprahepatic Inferior Vena Cava

Purpose The treatment of suprahepatic inferior vena cava (IVC) ruptures results in high mortality rates due to difficulty in performing the surgical procedure. Here, we present a case of successful endovascular management of a life-threatening suprahepatic IVC rupture with top-down placement of a stent graft. Case Report A 33-year-old woman was involved in a traffic accident and presented to our emergency department due to unstable hemodynamics after blunt abdominal wall trauma. Computed tomography (CT) revealed massive extravasation of contrast agent from the suprahepatic IVC, which suggested traumatic suprahepatic IVC rupture. To seal the IVC, to salvage major hepatic veins, and to prevent migration of the stent graft into the right side of the heart after placement, an aortic cuff with a proximal hook was introduced in a top-down direction via the right internal jugular vein. After closure of the injured IVC, the patient’s hemodynamics improved, and additional laparotomy was performed. After 3 months of trauma care, the patient recovered and was discharged. Follow-up CT after 58 months showed a patent stent graft within the IVC. Conclusion Endovascular management with top-down placement of a stent graft is a viable option for emergent damage control in patients with life-threatening hemorrhage from IVC rupture.

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