Duplication of the inferior vena cava and retroaortic left renal vein in a patient with large abdominal aortic aneurysm

Aortobifemoral bypass for occlusive aortic disease in a patient with a duplicate inferior vena cava

We present the case of a 66-year-old woman with severe aortoiliac occlusive disease (TASC-D) and an incidental finding of a left sided inferior vena cava, discovered on the preoperative computed tomography scan. This uncommon congenital finding can create intraoperative challenges to the vascular surgeon. In this case report, we have described this anatomic variant and elaborated on our surgical technique to suggest a few tips and tricks for addressing these cases.

Unusual coexistence of double inferior vena cava with nutcracker syndrome-a case report and review of the literature

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.

Duplicated Inferior Vena Cava in a Patient With Ampullary Adenocarcinoma: A Case Report and Literature Review of Anatomical Variations

Duplicated inferior vena cava (IVC) is a rare anatomical anomaly as a result of failed regression of the left supracardinal vein during the embryonic stage. This anatomical variation has certain surgical implications and could lead to potential catastrophe perioperatively. We hereby report a case of a 54 years old male in whom a whipple procedure was performed with type 1 duplicated IVC for ampullary adenocarcinoma. Review of current literature of such anatomical anomaly will also be discussed. This venous anomaly must be kept in mind in all surgical procedures involving the retroperitoneum to minimise the risk of incomplete lymph node dissection and life-threatening bleeding, and to guide management for deep vein thrombosis in the post-operative setting.

Wilms tumor with inferior vena cava duplication: a rare case report

Background

Wilms tumor is the most common renal tumor of childhood. Duplication of the inferior vena cava is an uncommon anomaly. In the present study, we present a case of Wilms tumor with the inferior vena cava duplication, which has not been reported previously.

Case presentation

A 14-month-old female presented with an enlarging abdominal mass. Computed tomography imaging demonstrated a large mass in the right kidney, duplication of the inferior vena cava below the renal veins and compression of the right inferior vena cava caused by the enormous mass. A right radical nephrectomy was performed. Final pathology was consistent with Wilms tumor. Postoperative adjuvant chemotherapy was executed. Computed tomography imaging at 3 months postoperatively showed the right inferior vena cava played a dominant role and the left inferior vena cava was not detected clearly. During the follow-up of 18 months, no local recurrence or metastasis has been observed.

Conclusion

It is important to recognize the case of Wilms tumor with the inferior vena cava duplication to avoid injury of retroperitoneal venous anomalies and life-threatening hemorrhage during surgery through preoperative computed tomography.

Electronic supplementary material

The online version of this article (10.1186/s12894-018-0401-0) contains supplementary material, which is available to authorized users.

Aneurysm sac enlargement 16 years after endovascular aortic aneurysm repair due to late type IIIb endoleak: A case report

INTRODUCTION

We report a case with delayed aneurysm sac enlargement 16 years after EVAR due to late type IIIb endoleak.

PRESENTATION OF CASE

An 84-year-old man was referred to our hospital with an aneurysm sac enlargement after endovascular aortic aneurysm repair (EVAR), which had been performed at another hospital 18 years earlier using the Zenith endograft. Computed tomography (CT), after EVAR had shown significant sac shrinkage. However, the patient presented with delayed aortic aneurysm enlargement due to an assumed endoleak. Duplex ultrasound showed a type IIIb and a type Ib endoleak. We performed a re-intervention with an AFX endograft, for relining due to persistent type IIIb endoleak.

DISCUSSION

Compared with the type IIIB endoleaks discussed in past reports, this case occurred with a much longer delay. Although CT could not identify the type of endoleak, duplex ultrasound led us to diagnose the type IIIb endoleak.

CONCLUSION

Relining using an ePTFE endograft may be considered an effective procedure for type IIIb endoleaks. Duplex ultrasound is useful for determining endoleak types.

Multiplanar imaging of inferior vena cava variants

Inferior vena cava (IVC) variants are rare and are usually detected incidentally. Even though, these variants are by themselves asymptomatic, they can have important clinical, radiological, and surgical implications. In this pictorial essay, we sensitize the reader to various IVC variants by presenting reports of actual patients. A succinct description of the embryological development of these anatomic variants is also provided.

Angiojet thrombolysis and vena cava filter insertion in a case of a duplicated inferior vena cava

Objectives:

Duplication of the inferior vena cava (IVC) complicates interventional procedures. This case report aims to shed light on this unusual anomaly and the preoperative considerations necessary when treatment of venous thromboembolism is undertaken.

Methods:

An IRB approved case report of a 58 year old woman presented emergently with right lower extremity phlegmasia due to extensive thrombosis of her right iliofemoral and infrarenal portion of her duplicated IVC.

Results:

The patient underwent IVC filter placement and rheolytic thrombectomy with thrombolysis using the Angiojet device followed by venoplasty and stenting of the iliofemoral system and right IVC. Complete symptomatic and radiographic resolution on duplex imaging was achieved at 1 year follow up.

Conclusions:

With adequate preoperative awareness of IVC anomalies and treatment options available satisfactory results can be achieved and complications minimized for this unique patient population.