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

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.

2011 ◽  
Vol 11 ◽  
pp. 1031-1035 ◽  
Author(s):  
Obi Ekwenna ◽  
Michael A. Gorin ◽  
Miguel Castellan ◽  
Victor Casillas ◽  
Gaetano Ciancio

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.


2018 ◽  
Vol 7 (03) ◽  
pp. 139-140
Author(s):  
Anly Antony ◽  
J. Sujitha Jacinth

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.


2019 ◽  
Vol 53 (7) ◽  
pp. 585-588
Author(s):  
Ewa J. Bialek ◽  
Bogdan Malkowski

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.


Phlebologie ◽  
2016 ◽  
Vol 45 (05) ◽  
pp. 322-324
Author(s):  
B. Burkert ◽  
Ph. Regeniter ◽  
A. Mumme ◽  
T. Hummel ◽  
D. Mühlberger

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.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Danilo Coco ◽  
Sara Cecchini ◽  
Silvana Leanza ◽  
Massimo Viola ◽  
Stefano Ricci ◽  
...  

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.


2017 ◽  
Vol 51 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Hilal Sahin ◽  
Yeliz Pekcevik ◽  
Ramazan Aslaner

The duplication of the inferior vena cava (IVC) is a rare congenital anomaly, which also has some variations regarding the complex embryological development of the IVC. In the typical form, infrarenal IVC segments are duplicated and the left IVC joins the left renal vein, which crosses anterior to the aorta in the normal fashion to join the right IVC. In variant forms, the interruption of the intrahepatic segment of the IVC, azygos or hemiazygos continuation, or retroaortic course of the renal vein may be seen. An intrahepatic venous shunt accompanying a double IVC variant is an extremely rare anomaly. We report a case of 40-year-old female patient with double IVC, hemiazygos continuation, intrahepatic IVC interruption, and a transhepatic venous shunt.


2021 ◽  
pp. 312-316
Author(s):  
Petru Bordei ◽  
Constantin Rusali ◽  
Constantin Ionescu ◽  
Dragos Serban ◽  
Valeriu Ardeleanu

The case was found on an organic sample consisting of the two kidneys with the renal pedicles and the corresponding segments of the abdominal aorta and inferior vena cava. From the inferior face of the left renal vein, on the lower side of the aorta, a venous branch with an upward path of 8.02 mm was detached, passing on the anterior face of the aorta, passing before its right side, in order to end on the left side of the inferior vena cava, 13.9 mm above the end of the left renal vein in the inferior vena cava, this branch thus describing a periaortic ring (necklace), in which on the left side of the aorta the inferior adrenal vein ends. The periaortic ring (necklace) had a cross-sectional dimension of 3.2 mm and a vertical one of 1.7 cm. On the right side of the aorta, a 2.9 mm venous branch came out of the renal vein, ending on the left side of the inferior vena cava, 1.2 mm above the end of the left renal vein. At the level of the right kidney there were two renal arteries, superior and inferior. Between the two arteries there was an interval of 5.1 cm.


2019 ◽  
Vol 70 (4) ◽  
pp. 1351-1356
Author(s):  
Petru Bordei ◽  
Elena Sapte ◽  
Corina Burcut ◽  
Razvan Hainarosie ◽  
Radu Cristian Jecan ◽  
...  

The formation level of the inferior vena cava in the vertebral column was found to be at the level of L3 -L4 and L5 - S1, with differences between genders. The total length of the inferior vena cava ranged between 187.10 and 278.3 mm. Interiliac angle measured 48.40 and 85.80o. The length of the IVC from its formation point up to the termination of the right renal vein in the IVC ranged between 78.50 and 135.0mm, and the length of the IVC from its formation point to the termination of the left renal vein into the IVC ranged between 89.80 and 119.0mm. The length of the IVC from its formation up to the termination of the hepatic veins ranged between 197.20 and 263.70mm. The diameter of IVC at the point of its formation ranged between 18.0 and 26.20 mm, at the level of the right infrarenal level ranged between 20.10 and 28.70 mm, in 78.08% of the cases. In female cases, the diameter ranged between 18.06 and 25.69 mm, the diameter of the IVC at the level of the right suprarenal ranged between 19.82 and 31.09mm, the diameter at the level of the left infrarenal ranged between 18.59 and 32.49mm, at the level of the left suprarenal vein ranged between 19.10 and 33,80 mm, the diameter at the intrahepatic level ranged between 20.30 and 33.40mm, and the diameter of the IVC at the suprahepatic level ranged between 23.10 and 37.0mm.


2006 ◽  
Vol 32 (3) ◽  
pp. 403-406 ◽  
Author(s):  
Sevdenur Cizginer ◽  
Servet Tatli ◽  
Jeffrey Girshman ◽  
Joshua A. Beckman ◽  
Stuart G. Silverman

2021 ◽  
Vol 104 (9) ◽  
pp. 1459-1464

Objective: To determine the prevalence of inferior vena cava (IVC) anomalies in Thai patients who underwent contrast-enhanced computed tomography (CT) of the abdomen. Materials and Methods: Two radiologists retrospectively and independently reviewed the contrast-enhanced abdominal CT examinations in 1,429 Thai patients between August 1, 2018 and January 25, 2019 who met the inclusion criteria. Patients were included, if (a) their CT showed well visualized IVC, renal veins, and right ureter that were not obliterated by tumor, cyst, fluid collection, or intraperitoneal free fluid, (b) they had not undergone previous abdominal surgery that altered anatomical configuration of the IVC, renal veins, and right ureter. The presence of all IVC anomalies were recorded. Results: Among the 1,429 studied patients, 678 were male (47.4%) and 751 were female (52.6%). The prevalence of IVC anomalies was 3.5%. Five types of IVC anomalies were presented. The most common was circumaortic left renal vein in 24 patients or 48.0% of all IVC anomalies and 1.7% of the study population, followed by retroaortic left renal vein in 15 patients or 30.0 % of all IVC anomalies and 1.0% of the study population. Other IVC anomalies included double IVC, left IVC, and retrocaval ureter at 0.5%, 0.2%, and 0.1% of the study population, respectively. Conclusion: The prevalence of IVC anomalies in the present study differed from the previous studies conducted in other countries, which may be attributable to differences in race and ethnicity. Awareness of these anomalies is essential when evaluating routine CT examinations in asymptomatic patients. Their presence should be carefully noted in radiology reports to avoid anomaly-related complications. Keywords: Prevalence; IVC anomalies; Circumaortic left renal vein; Retroaortic left renal vein; Double IVC; Left IVC; Retrocaval ureter


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