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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 duplicated IVC.
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Figure 0004: Transverse CT image of duplicated IVC.

Mentions: The persistence of both the right and left supracardinal veins leads to the development of a double IVC up to the level of the left renal vein. The duplicated left IVC joins the left renal vein, which in turn runs to the right to drain into the right IVC. The incidence of double IVC is 0.2-3.0% [4]. The condition is asymptomatic and usually diagnosed incidentally following abdominal imaging. Double IVC can be misdiagnosed as lymphadenopathy especially in patients being evaluated for renal surgery or neoplasm. Patients with double IVC are at risk of vascular injury during retroperitoneal procedures therefore identification prior to surgery is essential to avoid such complications. Some reports suggest that patients with double IVC have a higher risk of developing thromboembolic events [11–13]. Recurrent pulmonary embolism after the insertion of an IVC filter should also raise the suspicion of a double IVC. Figures 3a and 3b display coronal and axial CT images of a double 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 duplicated IVC.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0004: Transverse CT image of duplicated IVC.
Mentions: The persistence of both the right and left supracardinal veins leads to the development of a double IVC up to the level of the left renal vein. The duplicated left IVC joins the left renal vein, which in turn runs to the right to drain into the right IVC. The incidence of double IVC is 0.2-3.0% [4]. The condition is asymptomatic and usually diagnosed incidentally following abdominal imaging. Double IVC can be misdiagnosed as lymphadenopathy especially in patients being evaluated for renal surgery or neoplasm. Patients with double IVC are at risk of vascular injury during retroperitoneal procedures therefore identification prior to surgery is essential to avoid such complications. Some reports suggest that patients with double IVC have a higher risk of developing thromboembolic events [11–13]. Recurrent pulmonary embolism after the insertion of an IVC filter should also raise the suspicion of a double IVC. Figures 3a and 3b display coronal and axial CT images of a double 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