scholarly journals Intraoperative Cardiogenic Shock Caused by Intracardiac Tumor Thrombi Obstruction

2020 ◽  
Vol 3 (1) ◽  
pp. 15-17
Author(s):  
Yu KP ◽  
Lin YC ◽  
Chang JY

A 60-year-old man presented with left flank pain, a palpable abdominal mass, and hematuria for months. Computed tomography revealed a large tumor in the left kidney (approximately 17.7 cm in diameter) with evidence of left adrenal, left renal vein, and inferior vena cava (IVC) invasion. He underwent left nephrectomy with IVC thrombectomy. Transesophageal echocardiography (TEE) was used during the whole procedure and the tumor was found in the IVC (Fig-1) before resection.

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.


2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Sakir Ongun ◽  
Sermin Coban ◽  
Abdullah Katgi ◽  
Funda Obuz ◽  
Aykut Kefi

A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.


2018 ◽  
Vol 9 ◽  
pp. 215013271879902
Author(s):  
Allen L. Pimienta ◽  
Thomas A. Billings ◽  
Robert G. Fish

Renal cell carcinoma (RCC) accounts for approximately 80% of all primary renal neoplasms in United States causing approximately 65 000 new cases of RCC and 14 000 deaths each year. Symptoms of RCC typically include weight loss and night sweats but may also feature paraneoplastic phenomena in advanced stages as well as flank pain, gross hematuria, scrotal varicocele, inferior vena cava pathology, and a palpable abdominal mass. In this article, we present the course of a patient with advanced RCC, from initial presentation through workup and to eventual diagnosis. The case features late-onset symptoms, extensive paraneoplastic phenomena, and significant physical examination findings. We also review the literature available on RCC and critically analyze inefficiencies of the workup retrospectively.


2019 ◽  
Vol 54 (3) ◽  
pp. 283-285
Author(s):  
Krystal C. Maloni ◽  
Keith D. Calligaro ◽  
William Lipshutz ◽  
Kunal Vani ◽  
Douglas A. Troutman ◽  
...  

Nutcracker syndrome is a rare entity in which compression of the left renal vein (LRV), usually by the overlying superior mesenteric artery (SMA), results in renal venous congestion and reflux in the left ovarian vein (LOV). Patients may present with hematuria, left flank pain, dyspareunia, and vaginal or abdominal wall varicose veins. We report a patient with nutcracker syndrome who presented atypically with left flank pain that was exacerbated in the postprandial state. We hypothesize that the physiologic dilation of the SMA after oral intake caused increased LRV compression at that site and augmented lateral LRV distention. The patient had no evidence of SMA syndrome or chronic mesenteric insufficiency. Her symptoms resolved after we performed an LOV to inferior vena cava transposition.


2021 ◽  
Vol 14 (3) ◽  
pp. e237376
Author(s):  
Carlos Felipe Matute Martinez ◽  
Ahmad Hamdan ◽  
Juan Guillermo Sierra David ◽  
Swapna Kolli

Renal angiomyolipomas (AMLs) were first described in the early 1900s by Gravitz, but it was not until 1951 that they were named renal AML. These kidney tumours are rare, occurring in 0.13%–0.44% of the population. These mesenchymal tumours are composed of smooth muscle-like, adipocyte-like and epithelioid cells. Depending on the predominant cell population, it can be further subclassified into classic, epithelioid and AML with epithelial cyst. A 32-year-old woman presented with mild, intermittent, epigastric and right upper quadrant abdominal pain. Abdominal ultrasound revealed an incidental lesion within the inferior vena cava (IVC). A CT scan showed a lesion within the left renal vein extending into the IVC with 40% narrowing and a fat-containing mass in the lower pole of the left kidney of 15 mm suggesting an AML. Thrombectomy was performed. The specimen resulted positive for classic variant renal AML. Initial diagnosis is centred on imagining studies, based in fatty tissue concentration. The AML expresses melanocytic markers. This helps differentiate from renal cell carcinoma. Although AML is considered a benign condition, there is evidence of malignant transformation. Active surveillance is recommended for lesions <4 cm. Nephron sparing surgery is the procedure of choice. Nephrectomy is recommended if there is a high probability of malignancy. Mammalian target of rapamycin (mTOR) inhibitors have been proposed to be an alternative treatment.


2019 ◽  
Vol 5 (2) ◽  
pp. 20180091
Author(s):  
Mohamed Salah Elfeshawy

There is a wide range of congenital anomalies of the spleen regarding its shape, location, number, and size. Most of these congenital anomalies are commonly detected on ultrasonography, CT, or MRI and may sometimes represent a challenging diagnosis for radiologists and clinicians. The bilobed spleen is an extremely rare form of congenital anomaly. In most cases, it is accidentally discovered during abdominal surgeries. The bilobed spleen is usually large in size when compared with the normal spleen; hence, it is more liable to trauma. Transposition of the inferior vena cava (IVC; also known as left-sided IVC) refers to a very rare variant course of the IVC. The most common variations are duplicate IVC, as well as retroaortic left renal vein and circumaortic venous rings. Left-sided IVC occurs in 0.17–0.5% of the general population. Diagnosis of left-sided IVC is important when planning vascular procedures like portosystemic shunt, the placement of an IVC filter, nephrectomy, and renal transplant. There should be an awareness of the Riedel lobe, which is a common anatomical variant of the liver, as it can simulate a mass. Its misidentification as a pathological abdominal mass can lead to surgery; pathology can also occur (e.g. malignancy or even torsion). In this report, we presented a case of a bilobed spleen that was misdiagnosed as a left renal mass during routine abdominal ultrasonography in a 25-year-old female who complained of recurrent left hypochondrium pain. The bilobed configuration was confirmed with MRI and ultrasound examination of the abdomen.


Kanzo ◽  
1992 ◽  
Vol 33 (7) ◽  
pp. 531-540 ◽  
Author(s):  
Keiji TAICADA ◽  
Kenji NAKAMURA ◽  
Takao MANABE ◽  
Noriaki USUKI ◽  
Toshio KAMINOU ◽  
...  

Radiology ◽  
1983 ◽  
Vol 149 (1) ◽  
pp. 73-74 ◽  
Author(s):  
D R Voegeli ◽  
R P Lieberman ◽  
D R Yandow

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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