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Serratrice N, Manchon A, Prost S, Farah K, Bartoli JM, Tropiano P, Fuentes S, Blondel B. An updated classification of the anatomical variations of the internal iliac venous drainage system: Surgical implications for anterior lumbar spinal approaches. Neurochirurgie 2024; 70:101558. [PMID: 38614311 DOI: 10.1016/j.neuchi.2024.101558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2024] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Advanced pelvic surgery is associated with potential vascular risks. The aim of this study was to complete the existing classification of the anatomical variations of the internal iliac veins encountered on a series of preoperative angio CT with a view to performing anterior lumbar spine surgery. MATERIALS AND METHODS In this monocentric retrospective study conducted between 2010 and 2020, all preoperative angio CT performed before an anterior lumbar surgery were systematically analyzed. All the abnormalities of the iliac veins were referenced in an updated classification system. RESULTS 910 patients (431 men and 479 women) with a mean age of 49 years [16-88] were included. Apart from the most common variant in the population (type I), 64 anatomical variations (7.0%) in the iliac veins were reported and classified according to our new classification. The percentage of coverage of the L4-L5 intervertebral disc is 52%, including 32% by the inferior vena cava before the confluence of the common iliac veins. At the level of the L5-S1 intervertebral disc, the coverage is 30% (same distribution between left and right). CONCLUSIONS Variations of the iliac veins are frequent, and contrary to what one might think, and even if they can represent an anatomical trap during surgery, certain variations do not limit anterior lumbar spine surgery and are not more associated with vascular complications. Nevertheless, these anatomical variations must be known before any advanced pelvic surgery. Depending on their distribution, level L5-S1 is more suitable for ALIF, level L4-L5 for OLIF approaches.
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Affiliation(s)
- Nicolas Serratrice
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France; Laboratory of Anatomy, Aix-Marseille University, Provence-Alpes-Côte d'Azur, Marseille, France.
| | - Aurélie Manchon
- Department of Neuroradiology, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France; Aix Marseille Univ, CNRS, Institut de Neurosciences de La Timone, UMR 7289, Marseille, France
| | - Solène Prost
- Department of Spine Surgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
| | - Kaissar Farah
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
| | - Jean-Michel Bartoli
- Department of Neuroradiology, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
| | - Patrick Tropiano
- Department of Spine Surgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
| | - Stéphane Fuentes
- Department of Neurosurgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
| | - Benjamin Blondel
- Department of Spine Surgery, La Timone Hospital, Assistance Publique - Hôpitaux de Marseille, Provence-Alpes-Côte d'Azur, Marseille, France
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Manjatika AT, Mazengenya P, Davimes JG. Bilateral duplicated inferior vena cava associated with aberrant internal iliac and gonadal veins: A case-based narrative review. Ann Anat 2024; 253:152223. [PMID: 38295909 DOI: 10.1016/j.aanat.2024.152223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/09/2023] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND The left side anterior retroperitoneal approach is preferred for the management of lumbosacral spine disorders as there is reduced risk for vascular injury. The presence of multiple and uncommon venous variations on either side of the spine, like the bilateral duplicated inferior vena cava (DIVC), may complicate surgery in this region. The current study describes two rare cases of bilateral duplicated inferior vena cava associated with internal iliac and gonadal veins. METHODS The cases were identified during routine human dissections of the posterior abdominal wall of 89 (45 males, 44 females) individuals. The course, relations and morphometry of each duplicated inferior vena cava were examined and recorded. RESULTS Two (2.2%) of the 89 (1 male, 1 female) dissected individuals showed the presence of bilateral duplicated infrarenal segments of the inferior vena cava. In both cases, the pre-aortic trunk (vein) was the largest and the left inferior vena cava was the smallest. Both cases of bilateral DIVC presented with anomalous interiliac communicating veins, internal iliac veins, and drainage sites of the left gonadal veins. CONCLUSIONS The duplicated inferior vena cava may present with associated venous anomalies like those related to the gonadal and internal iliac veins. Knowledge of the duplicated inferior vena cava and its associated venous anomalies may be essential for accurately identifying and diagnosing vascular dysfunction and improving radiological interpretation across multiple surgical specialities.
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Affiliation(s)
- Arthur Tsalani Manjatika
- School of Anatomical Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa; School of Life Sciences, Anatomy Division, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Pedzisai Mazengenya
- College of Medicine, Ajman University, Ajman, United Arab Emirates; Center of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates; Faculty of Health Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa.
| | - Joshua Gabriel Davimes
- School of Anatomical Sciences, University of the Witwatersrand, Parktown, Johannesburg, South Africa
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Wu YL, Yang GK, Chen Q, Tang Y, Zhang JH, Wu SJ, Cai SL, Zhou YF, Zhu YB, Luo JW, Fang ZT. Case Report: Imaging features of a new type double inferior vena cava malformation and review. Front Cardiovasc Med 2023; 10:1298071. [PMID: 38111887 PMCID: PMC10726045 DOI: 10.3389/fcvm.2023.1298071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/09/2023] [Indexed: 12/20/2023] Open
Abstract
Background Double inferior vena cava (DIVC) is a rare vascular malformation. With advances in radiological techniques and diagnosis, more and more types of DIVC were identified and diagnosed. Recognition of the variety of DIVC seen on imaging is essential for subsequent venous interventions. Case presentation A 77-year-old man presented with low back pain with left lower limb pain for 1 month. Scattered petechiae above the skin surface on the left lower leg, especially on the extensor surface, with flaking and mild tingling of the skin, were noted 3 weeks ago. Ultrasound revealed deep vein thrombosis (DVT) in the left lower limb. Computed tomography pulmonary angiography (CTPA) suggested no significant thrombus in the pulmonary artery. Computed tomography venography (CTV) of bilateral lower limbs showed that iliac vein compression syndrome with formation of deep and superficial venous traffic branches in bilateral lower limbs, predominantly on the left side. CTV of the inferior vena cava (IVC) suggested that the left common iliac vein crossed the common iliac artery bifurcation from dorsal to ventral and continued to travel cranially as a ventral vessel, and connected with the ventral IVC anterior to the right common iliac artery. The right common iliac vein extended cephalad as a dorsal vessel, which was narrowed at the level of 4th lumbar vertebra by compression of the hyperplastic bone and the osteophyte. The patient was discharged after right and left common iliac vein angiography and balloon dilation of bilateral common iliac vein. Conclusion The formation of both ventrally and dorsally aligned DIVC is rarer. It should be clarified the effects of DIVC on DVT formation, and the importance of imaging for preoperative planning.
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Affiliation(s)
- Yu-lin Wu
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Guo-kai Yang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Qian Chen
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Yi Tang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Jian-hui Zhang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Shao-jie Wu
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Sen-lin Cai
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yan-feng Zhou
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
| | - Yao-Bin Zhu
- Department of Traditional Chinese Medicine, The First Affiliated Hospital, Fujian Medical University, Fuzhou, China
| | - Jie-wei Luo
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fuzhou, China
| | - Zhu-ting Fang
- Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
- Department of Interventional Radiology, Fujian Provincial Hospital, Fuzhou, China
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4
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Kawamura M, Yamashita S, Imaoka H, Shimura T, Kitajima T, Okugawa Y, Okita Y, Ohi M, Toiyama Y. Double inferior vena cava, an uncommon but relevant anatomical anomaly in surgery for lower rectal cancer: a report of two cases. Surg Case Rep 2023; 9:162. [PMID: 37704927 PMCID: PMC10499765 DOI: 10.1186/s40792-023-01738-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Double inferior vena cava (DIVC) is rare and usually detected incidentally. DIVC may be associated with several anatomical variants of the retroperitoneal and pelvic veins. These variants can pose a clinical problem during colorectal surgery. We present two patients with lower rectal cancer who also had a DIVC. CASE PRESENTATION Case 1 was a 72-year-old man with advanced lower rectal cancer (T3N0M0) who underwent robot-assisted low anterior resection after neoadjuvant therapy. A DIVC was detected on preoperative computed tomography (CT). During the operation, a presacral vein was injured while mobilizing the rectum and hemostasis could not be achieved. We converted to open surgery and packed the pelvic cavity for hemostasis. Retrospective analysis suggested the injured vein arose from an interiliac vein of the presacral pelvic venous plexus. Case 2 was a 50-year-old woman with lower rectal cancer (T3N0M0), immune thrombocytopenic purpura, and a DIVC. Although preoperative three-dimensional CT angiography showed no obvious pelvic vein abnormalities, a short course of preoperative radiotherapy was delivered to avoid lateral pelvic lymph node dissection. Chemotherapy was deferred owing to her thrombocytopenic disease. Laparoscopic abdominoperineal resection was performed meticulously to minimize bleeding and achieve rapid hemostasis. No intraoperative complications occurred. CONCLUSION DIVC is often accompanied by venous malformations that may pose a problem when mobilizing the mesorectum from the retroperitoneum. Preoperative assessment of pelvic vessel anatomy using three-dimensional CT is essential in patients with a DIVC who undergo rectal surgery.
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Affiliation(s)
- Mikio Kawamura
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Shinji Yamashita
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Hiroki Imaoka
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Tadanobu Shimura
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Takahito Kitajima
- Department of Genomic Medicine, Mie University Hospital, Tsu, Mie 514-8507 Japan
| | - Yoshinaga Okugawa
- Department of Genomic Medicine, Mie University Hospital, Tsu, Mie 514-8507 Japan
| | - Yoshiki Okita
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Masaki Ohi
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
| | - Yuji Toiyama
- Department of Gastrointestinal and Pediatric Surgery, Division of Reparative Medicine, Institute of Life Sciences, Mie University Graduate School of Medicine, Tsu, Mie 514-8507 Japan
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Korim F, Kuricová M, Eberlová L. Anatomical Characteristics of Duplicated Caudal Vena Cava in Cats-A Case Report. Animals (Basel) 2023; 13:ani13101585. [PMID: 37238015 DOI: 10.3390/ani13101585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Precise knowledge of the species-/breed-specific anatomy is important for accurate diagnosis and treatment. Existing literature has also been increasing in accordance with the growing demands of biomedical research, wherein mammals, including cats, have been used worldwide. Based on a vascular corrosion cast, complete duplication of the caudal vena cava (dCVC) was accidentally found in a 10-year-old male cat. The two separate symmetric veins corresponding to two caudal venae cavae cranially directed on both sides of the aorta; their first tributaries were the duplicated right and left deep circumflex iliac veins, and the median sacral vein ended in the right common iliac vein. At the L4 vertebra level, the left caudal vena cava crossed the aorta ventrally. It united with the right CVC immediately above the renal veins at the level of the cranial mesenteric artery (L2-L3). Embryologic knowledge is essential to understand the differences between the CVC variants in domestic mammals and the inferior vena cava in humans. However, views regarding the post-hepatic segment of the CVC during development vary considerably. Therefore, our case report also includes a summary of the CVC developmental theories and their clinical impact. We believe that this case and literature review contribute to the knowledge regarding the deep abdominal veins' variability, concomitant pathologies, and accurate diagnosis and surgery. Additionally, the latest robust studies demonstrating the exclusive participation of the caudal cardinal veins in the CVC development are discussed.
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Affiliation(s)
- Filip Korim
- Department of Morphological Disciplines, University of Veterinary Medicine and Pharmacy in Košice, 041 81 Košice, Slovakia
| | - Mária Kuricová
- Small Animal Clinic, University Veterinary Hospital, University of Veterinary Medicine and Pharmacy in Košice, 041 81 Košice, Slovakia
| | - Lada Eberlová
- Department of Anatomy, Faculty of Medicine, Charles University in Pilsen, 323 00 Pilsen, Czech Republic
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6
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Li W, Liao Z, Yao L, Zhang L, Xiao J, Dong Z. Retroperitoneal lymphoma with double inferior vena cava shown using a 3D visualization model: A case report and literature review. Exp Ther Med 2023; 25:156. [PMID: 36911367 PMCID: PMC9996295 DOI: 10.3892/etm.2023.11855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 01/20/2023] [Indexed: 02/22/2023] Open
Abstract
Cases of a retroperitoneal tumor with double inferior vena cava (IVC) are rarely reported. The present report documents a case of a retroperitoneal lymphoma with double IVC, and discusses its embryological, clinical and radiological significance. In addition, previous cases of a double IVC are reviewed. In the present report, a 52-year-old male patient was hospitalized for a retroperitoneal lymphoma tumor and double IVC. CT urography was performed, whilst a three-dimensional visualization model was also established based on CT data, to reveal a retroperitoneal tumor with double IVC. The present case involved a double IVC with interiliac vein, which was type 2b from the left IVC. The retroperitoneal tumor was identified to be a lymphoma measuring 116x83 mm by percutaneous puncture biopsy. Surgical treatment is generally not recommended for lymphoma. Therefore, this patient was transferred to the Hematology Department for treatment according to the lymphoma management guidelines. The size of the tumor was reduced after chemotherapy during the patient's follow-up. In conclusion, the three-dimensional visualization model can directly and accurately present the anatomical features of the double IVC and its surrounding tissue structure. In addition, variations in the features of IVC can have important clinical significance. It is also important for surgeons, interventional radiologists and clinicians to understand such abnormalities in anatomical features to avoid misdiagnosis and reduce the occurrence of serious intraoperative complications.
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Affiliation(s)
- Wanqiang Li
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Zhengquan Liao
- Department of Urology, Yidu People's Hospital, Yichang, Hubei 443300, P.R. China
| | - Ling Yao
- Intensive Care Unit, The First College of Clinical Medial Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Lusheng Zhang
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Jianhua Xiao
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
| | - Ziqiang Dong
- Department of Urology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, Hubei 443003, P.R. China
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7
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Muo EC, Iwanaga J, Olewnik Ł, Dumont AS, Tubbs RS. Duplication of the ovarian vein: comprehensive review and case illustration. Anat Cell Biol 2022; 55:251-254. [PMID: 35410982 PMCID: PMC9256477 DOI: 10.5115/acb.21.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/17/2022] [Accepted: 03/03/2022] [Indexed: 11/27/2022] Open
Abstract
Variations of the ovarian veins can impact imaging diagnosis, surgical procedures of the region, and can be related to clinical findings such as compression of the ureter. Therefore, a good working knowledge of such variants is important to the clinician who interprets imaging of the posterior abdominopelvic region of women and surgeons who operate in this region. Herein, we present a comprehensive review of duplicated ovarian veins and provide a case illustration.
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Affiliation(s)
- Edward C Muo
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joe Iwanaga
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - Łukasz Olewnik
- Department of Anatomical Dissection and Donation, Medical University of Lodz, Lodz, Poland
| | - Aaron S Dumont
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA
| | - R Shane Tubbs
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Anatomical Sciences, St. George's University, St. George's, Grenada.,Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Surgery, Tulane University School of Medicine, New Orleans, LA, USA.,Department of Neurosurgery and Ochsner Neuroscience Institute, Ochsner Health System, New Orleans, LA, USA.,University of Queensland, Brisbane, Australia
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8
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Yoshimura S, Yamamoto K, Fujimura S, Kawata S, Shimada K, Omotehara T, Itoh M. A case of double inferior vena cava with the connection to sacral venous plexus. Anat Sci Int 2021; 97:143-146. [PMID: 34797514 DOI: 10.1007/s12565-021-00640-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/06/2021] [Indexed: 11/28/2022]
Abstract
Double inferior vena cava (IVC) is known as a variation in which the additional IVC is found on the left side of the abdominal aorta. Their developmental process has been well documented, but the venous development around the lumbosacral region is controversial. In the present double IVC case, the left IVC entered the left renal vein at the L2 level, and the renal veins on each side flowed into the right IVC at the L1 level. The internal and external iliac veins were merged at the S1 level on each side. Besides, a venous communication (3-mm-width) was found horizontally between the internal iliac veins near their origin at the S1 level. It had also an extra narrow branch (1-mm-width), which ran obliquely upward and reached the left IVC at the level of L5. The median sacral artery (MSA) ran at the ventral side of the horizontal communication but at the dorsal side of its extra oblique branch. These results suggest that the oblique branch is a remnant of the anastomosis between the right and left posterior cardinal veins. Furthermore, the horizontal vein corresponds to the sacral venous plexus, suggesting that the anastomosis can be formed between the IVC and sacral venous plexus.
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Affiliation(s)
- Shiori Yoshimura
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Kentaro Yamamoto
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Shintaro Fujimura
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Shinichi Kawata
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Kazuyuki Shimada
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
| | - Takuya Omotehara
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan.
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University, 6-1-1, Shinjuku, Shinjuku-Ku, Tokyo, 160-8402, Japan
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9
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Variant formation of left common iliac vein by the confluence of four veins. Morphologie 2021; 106:203-205. [PMID: 34147368 DOI: 10.1016/j.morpho.2021.05.116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 05/29/2021] [Accepted: 05/30/2021] [Indexed: 11/24/2022]
Abstract
Common iliac vein variations are relatively rare compared to the variations of external and internal iliac veins. A rare pattern of formation of common iliac vein by the confluence of four veins is being reported here. The left common iliac vein was formed by the union of left external iliac vein, internal iliac vein, iliolumbar vein and a common trunk formed by the obturator and vesical veins. External iliac vein and obturator veins were connected by a communicating vein. Both external and common iliac veins were respectively medial to the external and common iliac arteries. Knowledge of this variant formation of common iliac vein could be useful to radiologists, gynecologists and orthopedic surgeons.
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10
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Nabri M, Alromaih NJ, Othman SA, Alghusnah ES, Abu Al Ola H, Elbagir A, Nasr AO. Blunt Abdominal Trauma Leading to an Incidental Finding of Duplicate Inferior Vena Cava (DIVC): A Case Report and Literature Review. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e929198. [PMID: 34061818 PMCID: PMC8183301 DOI: 10.12659/ajcr.929198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND With a prevalence of about 2% to 3%, duplication is the most common anomaly associated with the inferior vena cava (IVC). In general, systemic venous anomalies are being more frequently diagnosed in asymptomatic patients. We report the case of a young man with an incidental finding of an asymptomatic duplicated IVC, along with a literature review. CASE REPORT A 36-year-old man was brought to our Emergency Department (ED) following a high-speed motor vehicle collision (MVC), reporting right flank and hip pain. Upon examination, the "seatbelt sign" was noticed, along with abrasions over his right side. He sustained a small-bowel mesenteric injury, for which he was admitted and was treated conservatively. A CT scan incidentally revealed a duplicate IVC (DIVC). He later underwent a laparotomy with limited right hemi-colectomy and was discharged home in good condition. CONCLUSIONS Undiscovered and asymptomatic DIVCs pose a potential risk to patients during clinical interventions. Advancements in diagnostic imaging contribute greatly to the incidental discoveries of inferior vena cava duplication.
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Affiliation(s)
- Mamoun Nabri
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Norah J Alromaih
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Sharifah A Othman
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Elham S Alghusnah
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Hossain Abu Al Ola
- Department of Radiology, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Adel Elbagir
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - Ayman O Nasr
- Department of General Surgery, King Fahad Hospital of University, College of Medicine, and Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
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11
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Waśniewska A, Ruzik K, Olewnik Ł, Stefańczyk L, Polguj M. Unusual coexistence of double inferior vena cava with nutcracker syndrome-a case report and review of the literature. J Int Med Res 2020; 48:300060520904520. [PMID: 32089026 PMCID: PMC7110912 DOI: 10.1177/0300060520904520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Knowledge of vessel anomalies is significant for all specialists in clinical practice and may prevent serious complications following medical interventions. Here, the rare coexistence of a duplicated inferior vena cava (IVC) and nutcracker syndrome in a 42-year-old female patient with atypical abdominal pain is presented, using two complementary radiological techniques (colour Doppler ultrasonography and computed tomography angiography). The right renal vein was found to be compressed when passing between the superior mesenteric artery and the abdominal aorta. The lumen dimensions (width × height) of the right IVC and left IVC at the level of termination were 15.8 × 17.7 mm and 13.4 × 12.4 mm, respectively. Ultrasonography revealed low blood flow in the left IVC that was reversed, and thus blood travelled in the same caudal direction as in the aorta. In the right IVC, however, flow travelled in the cranial direction. The simultaneous existence of a duplicated IVC and nutcracker syndrome is an extremely rare vessel anomaly; nevertheless, this dual presence may result in clinical symptoms and would have an impact on medical operations and even minor medical procedures.
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Affiliation(s)
- Anna Waśniewska
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Łódź, Łódź, Poland
| | - Kacper Ruzik
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Łódź, Łódź, Poland
| | - Łukasz Olewnik
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Łódź, Łódź, Poland
| | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Łódź, Poland
| | - Michał Polguj
- Department of Normal and Clinical Anatomy, Chair of Anatomy and Histology, Medical University of Łódź, Łódź, Poland
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Hostiuc S, Minoiu C, Negoi I, Rusu MC, Hostiuc M. Duplication and transposition of inferior vena cava: A meta-analysis of prevalence. J Vasc Surg Venous Lymphat Disord 2019; 7:742-755. [DOI: 10.1016/j.jvsv.2019.01.063] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 01/27/2019] [Indexed: 12/26/2022]
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