Atypical variable origins of the left inferior phrenic artery and left gastric artery

OBJECTIVES

The current report describes the combined unusual origin of the left inferior phrenic and left gastric arteries observed during a routine dissection of the upper abdominal region.

BACKGROUND

The branches of the abdominal aorta are important vessels that supply blood to various organs and structures in the abdominal cavity. While there is typically a common pattern of branching, anatomical variations can occur, leading to differences in the branching patterns of the abdominal aorta.

METHODS

An accidental finding in an 80-year-old male cadaver within anatomical dissection was assessed.

RESULTS

We observed that the left inferior phrenic artery originated from the celiac trunk and gives off middle and superior suprarenal arteries, while the left gastric artery arose from the abdominal aorta independently.

CONCLUSION

The identification of anatomic vascular abnormalities of the abdominal aorta and its branches is clinically important in surgical and invasive arterial procedures and preoperative knowledge of vascular anomalies should prevent iatrogenic vascular trauma and complications during surgery (Fig. 3, Ref. 14).

Fused Right Supernumerary Kidney: A Case Report

Supernumerary kidney is a rare clinical entity with fused supernumerary kidney being even rarer. Caudally located fused right supernumerary kidney with multiple nephrolithiasis was diagnosed in a 69-years-old lady by Computed Tomography Urography. A separate renal artery arising from the abdominal aorta as well as separate renal vein draining into the inferior vena cava was present along with right sided bifid collecting system. Embryological basis of origin of supernumerary kidney, its diagnosis, clinical significance and management are discussed.

STARD-compliant article: Comparison of pulmonary sequestrations with thoracic and abdominal aortic arterial supply

Pulmonary sequestrations (PS) are typically supplied by a vessel originating from thoracic aorta, or abdominal aorta. Differences in imaging features between these PS subtypes have not been described.To analyze the imaging features of PS with arterial supply from the thoracic and abdominal aorta.Retrospectively, 23 pathologically proven cases of pulmonary sequestration were analyzed and compared based on the site of feeding artery origin.In 21 cases (21/23), the PS was soft tissue density. 1 (1/23) PS was purely cystic and another heterogeneous with both cystic and solid components (1/23). In 16/23 cases, the feeding vessel(s) arose from the thoracic aorta (male:female ratio 1:7) and in 7/23 cases from the abdominal aorta (male:female ratio 4:3). Feeding vessels from the thoracic aorta were duplicated in 7/16 cases. PS location (P <.05) and size (P <.001) differed based on the origin of the feeding vessel (thoracic aorta: 14/16 left lower lobe, mean volume 962.97 mL; abdominal aorta: 3/7 left lower lobe, mean volume 1120.89 mL). The feeding arteries themselves differed in size depending on their site of origin (thoracic aorta: mean diameter 7.0mm ± 2.7 mm, mean length 44.6mm ± 10.9 mm; abdominal aorta: mean diameter 3.3mm ± 0.6 mm, mean length 103.6mm ± 34.5 mm).PS size and distribution differ depending upon the site of feeding vessel origin as does the size of the feeding vessel itself.

Surgical Repair of a 13-cm Infrarenal Abdominal Aortic Aneurysm with Aortocaval Fistula in a 63-Year-Old Tuba Player

Infrarenal abdominal aortic aneurysm with aortocaval fistula, a rare condition, can be fatal without prompt intervention. The clinical symptoms are complex and varied, so diagnosis is typically confirmed by use of contrast-enhanced multidetector computed tomography. We report our surgical repair of a 13-cm-diameter infrarenal abdominal aortic aneurysm and aortocaval fistula in a 63-year-old orchestral tuba player who had 2 classic symptoms of the condition. The unruptured aneurysm and fistula were complicated by acutely angled vessels, so we performed surgery rather than endovascular repair. The patient recovered fully and was discharged from the hospital. This infrarenal aneurysm with aortocaval fistula is perhaps the largest to have been treated successfully by means of open surgery. In addition to our patient's case, we discuss the history and treatment considerations of this rare combined condition.

Multiple variations of collateral branches of the abdominal aorta associated with pyelic duplication: A case report

PURPOSE

We describe a rare case of anatomical variation of the collaterals of the abdominal aorta associated with a duplication of the pyelic.

MATERIAL AND METHOD

A 51-year-old patient in whom an abdominal CT scan was performed as part of the exploration of a cystic left renal mass objectified on ultrasound.

RESULTS

A celiomesenteric trunk with two left renal arteries and a duplication of the left pyelon were found.

CONCLUSION

The reported case is of interest in the rare association of these anatomical variants.

Aorto-caval fistula resulting from an abdominal aortic aneurysm: A case report from the Emergency Department of Izmir Bozyaka Training and Research Hospital, Turkey

The rupture of an abdominal aortic aneurysm into the inferior vena cava with fistula formation is a rare condition but is associated with high mortality. Classical symptoms and findings vary in a wide range, and early diagnosis and intervention can be life-saving. In this study, we present a case of abdominal aortic aneurysm associated with aorto-caval fistula formation accompanied by mortality.

[Aorto-cava fistula complicating abdominal aorta aneurysm]

We report here a case of aorto-cava fistula complicating the rupture of a sub-renal aortic aneurysm into the inferior vena cava, which is a rare complication of aortic abdominal aneurysms with often-fatal outcome. Abdominal computed tomography with multi-planar reconstructions remains the firstline-imaging tool allowing positive diagnosis and preoperative planning. Treatment may be surgical or endovascular.

An anomalous origin of the gastrosplenic trunk and common hepatic artery arising independently from the abdominal aorta: a case report using MDCT angiography

The authors describe a case of a 61-year-old female patient, which presented on multidetector computed tomographic (MDCT) angiography a gastrosplenic trunk (GST) and common hepatic artery (CHA) arose independently from abdominal aorta (AA). The GST arose from the anterior wall of the AA, at the level of upper edge of the L1 vertebral body. The left gastric artery (LGA) arose from the superior wall of the GST. The splenic artery (SA) continuous the path of GST. The CHA arose from the anterior wall of the AA, at the level of upper one third of the L1 vertebral body, at 15.3 mm above the origin of superior mesenteric artery (SMA). The incidence and developmental and clinical significance of this vascular variation is discussed with a detailed review of the literature.

Evaluation of pulmonary sequestration with multidetector computed tomography angiography in a select cohort of patients: A retrospective study

OBJECTIVES

This study aimed to evaluate the role of multidetector computed tomography angiography in diagnosing patients with pulmonary sequestration.

METHODS

We retrospectively analyzed the computed tomography studies and clinical materials of 43 patients who had undergone preoperative multidetector computed tomography angiography in our hospital and had pathologically proven pulmonary sequestration. Each examination of pulmonary sequestration was reviewed for type, location, parenchymal changes, arterial supply and venous drainage on two-dimensional and three-dimensional computed tomography images.

RESULTS

Multidetector computed tomography successfully detected all pulmonary sequestrations in the 43 patients (100%). This included 40 patients (93.0%) with intralobar sequestration and 3 patients (7.0%) with extralobar sequestration. The locations of pulmonary sequestration were left lower lobe (28 cases, 70% of intralobar sequestrations), right lower lobe (12 cases, 30% of intralobar sequestrations) and costodiaphragmatic sulcus (3 cases). Cases of sequestered lung presented as mass lesions (37.2%), cystic lesions (32.6%), pneumonic lesions (16.3%), cavitary lesions (9.3%) and bronchiectasis (4.6%). The angioarchitecture of pulmonary sequestration, including feeding arteries from the thoracic aorta (86.1%), celiac truck (9.3%), abdominal aorta (2.3%) and left gastric artery (2.3%) and venous drainage into inferior pulmonary veins (86.0%) and the azygos vein system (14.0%), was visualized on multidetector computed tomography. Finally, the multidetector computed tomography angiography results of the sequestered lungs and angioarchitectures were surgically confirmed in all the patients.

CONCLUSIONS

As a noninvasive modality, multidetector computed tomography angiography is helpful for making diagnostic decisions regarding pulmonary sequestration with high confidence and for visualizing the related parenchymal characteristics, arterial supply, and venous drainage features to help plan surgical strategies.

Infantile Renovascular Hypertension with Failure to Thrive

Severe hypertension in infancy is a rare cause of failure to thrive. The successful surgical management of this disease in an infant having refractory renovascular hypertension and growth failure is reported.

Celiacomesenteric trunk: a rare anatomical variation with potential clinical and surgical implications

The arterial supply of the abdominal viscera is derived via three single arteries: the celiac axis, the superior mesenteric artery, and the inferior mesenteric artery. These arteries usually originate separately from the ventral aspect of the abdominal aorta. In some cases, two or more of these arteries may originate from a common trunk. The celiacomesenteric trunk is a rare condition that can generate clinical and surgical complications. Preoperative knowledge of vascular anomalies is critical when planning a surgical approach. We report a patient who underwent Multi-detector Computed Tomography (MDCT) before a vascular procedure, and a common trunk for celiac axis and superior mesenteric artery (celiac mesenteric trunk) was incidentally found.

Anomalous pattern of origin of the left gastric, splenic, and common hepatic arteries arising independently from the abdominal aorta

The celiac trunk is the first unpaired midline branch of the abdominal aorta that usually gives rise to the left gastric artery (LGA), the common hepatic artery (CHA) and the splenic artery (SpA). Despite this classic arrangement, many variations exist. We describe an atypical case of an absent CT and anomalous origin of the LGA, CHA and the SpA from the abdominal aorta using multidetector computed tomography angiography (MDCTA) in a 72-year-old male patient. The LGA arose from the anterior wall of the AA at the level of the T12-L1 intervertebral disk [33.8 mm above the origin of the superior mesenteric artery (SMA)]. The SpA originated directly from the anterolateral wall of the AA at the junction of the upper-third and middle-third of the L1 vertebral body (24.8 mm above the origin of the SMA). The CHA branched directly from the anterior wall of the AA at the level of the middle-third of the L1 vertebral body (17 mm above the origin of the SMA). The 64-slice MDCTA system has become the primary tool for evaluation of abdominal blood vessels. It is important to be aware of such a variation as it can have a significant impact on surgical and clinical practice.

Clinical recognition of mid-aortic syndrome in children

Mid-aortic syndrome is characterized by narrowing of the abdominal aorta, usually with the involvement of renal arteries and other visceral branches. The combination of the presence of an abdominal bruit, diminished or absent pulsations of the lower extremities, and a blood pressure discrepancy between upper and lower extremities is the classic triad associated with mid-aortic syndrome. However, it has a wide variety of clinical symptoms, and awareness of the variable presentation can lead to early diagnosis of the vascular anomaly. We report three cases presenting at three different stages of this disease, such as hydrops fetalis, refractory hypertension, and intracerebral bleeding. In conclusion, these cases highlight the importance of blood pressure measurements in all patients and accurate physical examination for early recognition of a mid-aortic syndrome.

Rare urogenital malformation associated with complex vascular malformation -- case report

BACKGROUND

Class 3 urogenital malformations are a rarely encountered in the clinical setting. The association with complex vascular malformations represent a challenge in diagnosis and intraoperative management with an enhanced degree of the complexity.

CASE PRESENTATION

Young female presented to the emergency department with pain in the left lower quadrant and unspecific abdominal symptoms that appear regularly one week prior and during her menstruation. Diagnostic studies and intraoperative findings lead to the diagnosis of a rare urogenital malformation associated with complex vascular malformations. In conclusion the most helpful diagnostic study was the abdominal MRI. Regarding the functional status of the postoperative urogenital tract no clear assessment can be made yet.

Mid-aortic syndrome in a 3-year-old girl successfully treated by aorto-aortic grafting and renal artery implantation into the graft

Mid-aortic syndrome, an uncommon acquired or congenital condition characterized by segmental narrowing of the abdominal or distal descending thoracic aorta, is frequently accompanied by ostial stenosis of the aorta's branches. If left untreated, it can result in life-threatening complications secondary to severe hypertension.We report the case of a 3-year-old girl with congenital mid-aortic syndrome, who was diagnosed by chance in the course of a viral illness, and whose high blood pressure values were first dismissed as inaccurate. Attempts to achieve medical or endovascular control of her hypertension were unsuccessful. She was thereafter successfully treated by aorto-aortic bypass grafting, resection of the stenotic segments of both renal arteries, and implantation of the patent arterial segments into the graft.

Mid aortic syndrome: a rare vascular disorder

Coarctation of abdominal aorta, Middle aortic syndrome (MAS) is a rare disease with only 200 reported cases. MAS may present clinically as uncontrolled hypertension, abdominal claudication or lower limb claudication. Surgical treatment is effective in controlling symptoms and improves life expectancy. We present another case of this rare entity, diagnosed and treated at Armed Forced Institute of Cardiology and Combined Military Hospital, Rawalpindi. This is the second reported case of MAS diagnosed and treated in Pakistan.

A case of the inferior mesenteric artery arising from the superior mesenteric artery in a Korean woman

Anatomical variations of the inferior mesenteric artery are extremely uncommon, since the inferior mesenteric artery is regularly diverged at the level of the third lumbar vertebra. We found a rare case in which the inferior mesenteric artery arose from the superior mesenteric artery. The findings were made during a routine dissection of the cadaver of an 82-yr-old Korean woman. This is the tenth report on this anomaly, the second female and the first Korean. The superior mesenteric artery normally arising from abdominal aorta sent the inferior mesenteric artery as the second branch. The longitudinal anastomosis vessels between the superior mesenteric artery and inferior mesenteric artery survived to form the common mesenteric artery. This anatomical variation concerning the common mesenteric artery is of clinical importance, performing procedures containing the superior mesenteric artery.

Multiple aberrant coeliac trunk ramifications

This study describes a routine educational cadaveric dissection, where multiple aberrant coeliac trunk branches were noticed. Specifically, the accessory left hepatic artery emerged from the left gastric artery, while the left inferior phrenic artery originated from the coeliac trunk. The accessory left suprarenal artery was found to commence from the coeliac trunk, whereas two aberrant left suprarenal arteries branched separately from the origin of the left inferior phrenic artery. Finally, the accessory jejunal artery was observed to originate from the coeliac trunk. Anatomical variations of the coeliac trunk branches can significantly alter the surgical management of the upper abdomen; hence, clinicians and radiologists should be aware of such aberrant vascular anatomy so as to reduce the incidence of surgical complications.

Anomalous origin of the right pulmonary artery from the abdominal aorta with aberrant right subclavian artery and left patent ductus arteriosus

Anomalous origin of the pulmonary artery (AOPA) from the aorta is a rare congenital heart malformation. This report describes a case of AOPA from the abdominal aorta in association with an aberrant right subclavian artery and a patent ductus arteriosus, which never has been reported previously in the literature.

Multiple variations of the abdominal aorta in a single cadaver

Numerous variations of the abdominal aorta were observed during a routine dissection of the abdominal region in a 60-year-old male cadaver in the Department of Anatomy, Meram Faculty of Medicine, Selcuk University, Turkey. In the present case, a common inferior phrenic trunk arose from the abdominal aorta and then divided into two branches. The left gastric artery arose from the front of the abdominal aorta, with an accessory right hepatic artery arising from the superior mesenteric artery. Although the single right renal artery originated from the abdominal aorta, double left renal arteries were found to originate from the abdominal aorta. Knowledge of these variations could help surgeons to identify and protect the abdominal aorta during surgery.

[A rare vascular malformation of the lung: discussion of the CT findings and nomenclature]

OBJECTIVE

To investigate the characteristic findings of an anomalous systemic arterial supply to the lung without the pulmonary artery on spiral CT and discuss its nomenclature.

METHODS

Four cases of anomalous systemic arterial supply to the left basal segment of the lung without the pulmonary artery were retrospectively reviewed with analysis of the characteristic CT findings.

RESULTS

On spiral CT scans, the involved left lower lung including the entire left basal segments (n=2), the lateral and posterior basal segment (n=1), and the anterior, medial, and posterior basal segment (n=1) had mild volume loss and areas of ground-glass opacity but with normal bronchial trees. The absence of the entire or part of the basal segments of the normal left lower lobar pulmonary artery, anomalous systemic artery originating from the abdominal aorta, diffuse dilatation of the systemic arterial branches distributed in the basal segments of the left lower lobe, and left lower pulmonary venous drainage into left atrium were found in all these patients.

CONCLUSION

This anomaly presents with characteristic findings on chest spiral CT, for which the nomenclature of local absent pulmonary artery better shows the characteristics of the disease.

Hepato-spleno-mesenteric trunk: a case report

Hepatic, splenic and left gastric arteries are the "classical branches" of celiac trunk. The authors report a rare variation, hepato-spleno-mesenteric trunk with two classical branches of celiac trunk and superior mesenteric artery having common origin from the abdominal aorta. The third classical branch of the celiac trunk (left gastric artery) was directly arising from the abdominal aorta. Knowledge of variations concerning the celiac trunk and superior mesenteric arteries are of great important for both surgical approaches and angiographic examinations.

Multiple variations in the branching pattern of the abdominal aorta

We report on a unique clinically and surgically significant case of multiple abdominal aorta variations. Specifically, the left inferior phrenic, left gastric and splenic artery arose in common from the left aspect of the aorta constituting a common phrenogastrosplenic trunk, while the common hepatic artery originated separately from the midline of the anterior aspect of the aorta just inferiorly to the trunk. An accessory right hepatic artery arises from the right-anterior aspect of the abdominal aorta adjacent to superior mesenteric artery origin. On the left side, two renal arteries were observed. Moreover, the left gonadal artery exhibited a high origin, arising inferiorly to the upper left renal artery. We discuss about the embryological development of abdominal aorta arterial abnormalities and we attempt to sort the noticed variations according to existing classification in the literature. It is highlighted that the thorough knowledge of these arterial variations is important for the success of upper abdomen surgical operations such as liver and kidney transplantation, kidney preservation, abdominal aorta related vascular surgery, treatment of hepatocellular carcinoma by transcatheter arterial chemoembolizations as well as imaging interpretation of the region. Preoperative selective angiography or other abdominal aorta imaging studies are helpful for arterial variation demonstration and a precious tool for appropriate surgery planning.

Bifurcated Abdominal Aorta, with a Coarctation over the Right Branch of the Bifurcated Abdominal Aorta and Aberrant Renal Arteries Originating from the Left Branch of the Bifurcated Abdominal Aorta

This study describes an unusual case of secondary hypertension in a young female patient presenting with severe hypertension and abdominal bruits. Gadolinium-enhanced MRA revealed a clearly bifurcated abdominal aorta, with a coarctation over the right branch of the bifurcated abdominal aorta and aberrant renal arteries originated from the left branch of the bifurcated abdominal aorta. Of interest is conventional angiography had failed to reveal these vascular abnormalities. This study mentions both embryologic and clinical aspects of this developmentally abnormal bifurcated abdominal aorta, coarctation of abdominal aorta and aberrant renal arteries.

Bilateral triple renal arteries

Knowledge of the variations of the renal artery has grown in importance with increasing numbers of renal transplants, vascular reconstructions and various surgical and radiologic techniques being performed in recent years. We report the presence of bilateral triple renal arteries, discovered on routine dissection of a male cadaver. On the right side, one additional renal artery originated from the abdominal aorta (distributed to superior pole of the kidney) and one other originated from the right common iliac artery (distributed to lower pole of the kidney). On the left side, both additional renal arteries originated from the abdominal aorta. Our observation has been compared with variations described in the literature and their clinical importance has been emphasized.

Mid-aortic syndrome with renovascular hypertension and multisystem involvement in a girl with familiar neurofibromatosis von Recklinghausen type 1

OBJECTIVES

Neurofibromatosis von Recklinghausen type 1 (NF1) is an autosomal dominant neurocutaneous disorder affecting one in 3 000-4 000 individuals. Mid-aortic syndrome (MAS) is a rare condition characterized by segmental narrowing of abdominal aorta and stenosis of its major branches - mainly renal arteries, including manifestation of renovascular hypertension. MAS can be caused by different diseases, including NF1.

MAIN FINDINGS

A 9 years old girl with primary diagnosis of NF1 combined with renovascular hypertension due to MAS, suffered of bilateral optic and chiasm glioma, pubertas praecox, speech disorder, light mental retardation and scoliosis. We have found a mutation in exone 34 of the NF1 gene (17q11.2). Her father has been also diagnosed with NF1 and hypertension developed at early age. He has the same mutation in exone 34 of NF1 gene. The girl is currently treated with conservative antihypertensive medication with positive effect. Bilateral optic and chiasm glioma are asymptomatic at the time and they had been without progress over period of time. Any vascular surgery, neurosurgical and oncological therapy are not indicated at the present time.

CONCLUSION

This article is a summary of clinical findings in patient with NF1 due to NF1 gene mutation in exone 34. It confirms the importance of complex multidisciplinar approach to examination and taking care of NF1 patients and their families.

[Rare variation of abdominal aorta breaking in two]

OBJECTIVE

To discuss a rare variation of abdominal aorta breaking in two.

METHODS

An in-patients, female, aged 76, admitted for asthenia of right extremities, underwent gadolinium-enhanced magnetic resonance angiography (MRA) of cerebral and abdominal vessels and abdominal MRI in whom the conventional angiography had failed to reveal this vascular abnormality.

RESULTS

MRA showed a clearly separated abdominal aorta. The upper part of the abdominal aorta terminated under the two renal artery branches and the lower part terminated at the level of L(3 - 4). The compensated enlarged superior and inferior mesenteric artery connected these two isolated parts of abdominal aorta.

CONCLUSION

This rare variation of abdominal aorta without any symptom is probably caused by some external force during the embryonic period.

A novel formula for the classification of blood vessels according to symmetry, asymmetry and hypoplasia

A new mathematical formula for calculating the symmetry, asymmetry and hypoplasia of blood vessel segments is presented for discussion. The study was conducted using the computed tomography (CT) files from 80 patients (34 men and 46 women) from the Silesian University Hospital, Silesia, Poland, who were between the ages of 12 to 76 and had undergone CT angiography of the circle of Willis. With the use of Gradual Angiographic Image Data Analyser software and double shuttled glasses, CT files were reconstructed. In addition, 80 renal arteries (RAs) from spontaneously aborted foetuses ranging in age from 14 to 30 weeks (24 male and 16 female) were injected with latex and also included in the study. Digital images of the RAs were taken using a Camedia 4040 camera and analysed using original analysis software. A novel formula entitled the Vascular Asymmetry Coefficient (VAC) was derived for this purpose and displays the differences between the mean diameters of blood vessel segments expressed as a percentage of the wider vessel with respect to the major diameter. The asymmetrical classification for a vascular segment of a vessel is given when the difference between the mean diameters of the vascular segment, as represented by the wider vessel, is greater than VAC > 10%. The hypoplastic classification is reserved for blood vessels where the difference between the diameter of the two segments is expressed as a percentage of the wider vessels and is greater than VAC > 40%. While there have been inconsistent and arbitrary classifications for the qualitative criteria of blood vessels, this newly presented algorithm can be used as a standardised tool and has a considerable range of uses, particularly when comparing blood vessel symmetry, asymmetry and hypoplasia prior to bifurcation, and unification.

Percutaneous Nitinol Stent Implantation in the Treatment of Nutcracker Syndrome in Young Adults

The present report describes three young adults with nutcracker syndrome caused by left renal vein stenosis managed with nitinol stent implantation. The patients treated included a 20-year-old woman with persistent microhematuria and dyspareunia and two 18-year-old men with proteinuria, hematuria, and flank pain. All three patients were asymptomatic after a follow-up of 14-18 months.

Unusual congenital aortic anomaly with rare common celiamesenteric trunk variation: MR angiography and digital substraction angiography findings

Magnetic resonance angiography and digital substraction angiography (DSA) findings in a case with a rare congenital thoracoabdominal aortic hypoplasia and common celiamesenteric trunk variation with occlusion of infrarenal abdominal aorta are described here. To our knowledge, this aortic anomaly has not been previously described in the English literature. DSA is the optimum imaging modality for determination of aortic hypoplasia, associated vascular malformations, collateral vessels, and direction of flow within vessels.

Incidence of the retroaortic left renal vein in patients with varicocele

OBJECTIVE

The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele.

METHODS

The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery.

RESULTS

The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively.

CONCLUSIONS

In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.

[Abdominal vascular malformations and Down syndrome]

Malformations of the abdominal venous system are rare vascular disorders. These entities are associated with other malformations and with chromosomal anomalies such as trisomy 21. Abdominal venous malformations are probably the most frequent congenital vascular malformations in Down syndrome. Prenatal diagnosis allows the early follow-up and treatment of complications. We present a case of Down syndrome associated with an abdominal venous malformation diagnosed at the first trimester of pregnancy.