Limits...
Anomalies of the inferior vena cava and renal veins and implications for renal surgery.

Eldefrawy A, Arianayagam M, Kanagarajah P, Acosta K, Manoharan M - Cent European J Urol (2011)

Bottom Line: The embryological development of the IVC is complex and involves the development and regression of three sets of paired veins.There may be significant hemorrhage or damage to vascular structures.In addition, aberrant vessels may be mistaken for lymphadenopathy and may be biopsied.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.

ABSTRACT
Abnormalities of the inferior vena cava (IVC) and renal veins are extremely rare. However, with the increasing use of computed tomography (CT), these anomalies are more frequently diagnosed. The majority of venous anomalies are asymptomatic and they include left sided IVC, duplicated IVC, absent IVC as well as retro-aortic and circumaortic renal veins. The embryological development of the IVC is complex and involves the development and regression of three sets of paired veins. During renal surgery, undiagnosed venous anomalies may lead to major complications. There may be significant hemorrhage or damage to vascular structures. In addition, aberrant vessels may be mistaken for lymphadenopathy and may be biopsied. In this review we discuss the embryology of the IVC and the possible anomalies of IVC and its tributaries paying particular attention to diagnosis and implications for renal surgery.

No MeSH data available.


Related in: MedlinePlus

Transverse CT image of the left IVC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3921701&req=5

Figure 0002: Transverse CT image of the left IVC.

Mentions: The infrarenal part of the IVC develops from the supracardinal vein. Regression of the right supracardinal vein and persistence of the left supracardinal vein lead to the development of the infrarenal IVC on the left side and the suprarenal IVC on the right side [6]. The IVC crosses to the right side at the level of the renal veins anterior to the aorta. Crossing of the IVC posterior to the aorta has also been reported [5]. The incidence of left IVC is 0.2–0.5% [7]. In the presence of a left IVC, the normal venous anatomy may be reversed. The left gonadal and adrenal veins drain directly into the left IVC while the right gonadal and adrenal veins drain into the right renal vein, which is then joined by the left IVC as it crosses the midline to lie on the right side at the level of the renal veins. The anomaly is usually silent and is found on preoperative imaging. The identification of a left IVC is critical prior to vascular procedures, particularly nephrectomy or adrenalectomy. In addition, a left IVC has been associated with other anomalies such as multiple renal veins and care must be taken during hilar dissection [8]. The risk of vascular injury is even higher if not identified prior to surgery or when the right renal vein crosses posterior to the aorta [9]. A left IVC can also be misdiagnosed as lymphadenopathy and cases exist in the literature where lymph node dissection has been attempted or chemotherapy administered [10]. Figures 2a and 2b display transverse and coronal CT images of a patient with left IVC.


Anomalies of the inferior vena cava and renal veins and implications for renal surgery.

Eldefrawy A, Arianayagam M, Kanagarajah P, Acosta K, Manoharan M - Cent European J Urol (2011)

Transverse CT image of the left IVC.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921701&req=5

Figure 0002: Transverse CT image of the left IVC.
Mentions: The infrarenal part of the IVC develops from the supracardinal vein. Regression of the right supracardinal vein and persistence of the left supracardinal vein lead to the development of the infrarenal IVC on the left side and the suprarenal IVC on the right side [6]. The IVC crosses to the right side at the level of the renal veins anterior to the aorta. Crossing of the IVC posterior to the aorta has also been reported [5]. The incidence of left IVC is 0.2–0.5% [7]. In the presence of a left IVC, the normal venous anatomy may be reversed. The left gonadal and adrenal veins drain directly into the left IVC while the right gonadal and adrenal veins drain into the right renal vein, which is then joined by the left IVC as it crosses the midline to lie on the right side at the level of the renal veins. The anomaly is usually silent and is found on preoperative imaging. The identification of a left IVC is critical prior to vascular procedures, particularly nephrectomy or adrenalectomy. In addition, a left IVC has been associated with other anomalies such as multiple renal veins and care must be taken during hilar dissection [8]. The risk of vascular injury is even higher if not identified prior to surgery or when the right renal vein crosses posterior to the aorta [9]. A left IVC can also be misdiagnosed as lymphadenopathy and cases exist in the literature where lymph node dissection has been attempted or chemotherapy administered [10]. Figures 2a and 2b display transverse and coronal CT images of a patient with left IVC.

Bottom Line: The embryological development of the IVC is complex and involves the development and regression of three sets of paired veins.There may be significant hemorrhage or damage to vascular structures.In addition, aberrant vessels may be mistaken for lymphadenopathy and may be biopsied.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Miller School of Medicine, University of Miami, Miami, FL, USA.

ABSTRACT
Abnormalities of the inferior vena cava (IVC) and renal veins are extremely rare. However, with the increasing use of computed tomography (CT), these anomalies are more frequently diagnosed. The majority of venous anomalies are asymptomatic and they include left sided IVC, duplicated IVC, absent IVC as well as retro-aortic and circumaortic renal veins. The embryological development of the IVC is complex and involves the development and regression of three sets of paired veins. During renal surgery, undiagnosed venous anomalies may lead to major complications. There may be significant hemorrhage or damage to vascular structures. In addition, aberrant vessels may be mistaken for lymphadenopathy and may be biopsied. In this review we discuss the embryology of the IVC and the possible anomalies of IVC and its tributaries paying particular attention to diagnosis and implications for renal surgery.

No MeSH data available.


Related in: MedlinePlus