Absence of the right iliac vein and an unusual connection between both common femoral veins

A rare femoral venous ladder encircling the femoral artery

Femoral vein is increasingly used for venous cannulation procedures. Its anomalies in the femoral triangle could complicate these procedures. We report an extremely rare type of femoral venous ladder observed during routine cadaveric dissections. The variation was found in the left lower limb of an adult male cadaver aged 70 years. The femoral vein was a single vein in initial 3 cm and terminal 4 cm of its course. The middle part of the vein showed a duplication and a complex ladder pattern and encircled the femoral artery in the femoral triangle. This anomaly could predispose the vein for deep vein thrombosis. Knowledge of this anomaly could be useful during radiological procedures, femoral hernia repair and femoral triangle abscess and lymph node clearance.

Congenital absence of the left external iliac vein with anomalous venous connection in a pediatric patient

We report an interesting case of a 2-year-old boy with congenital absence of the left external iliac vein and an anomalous lower extremity venous connection. Magnetic resonance imaging was used to identify aplasia of the vessel and aid in the diagnostic algorithm. In the present report, we have discussed the relevant literature associated with congenital venous anomalies and their clinical presentations and treatment options. Our patient did not undergo surgical intervention for his vascular malformation.

Congenital bilateral iliac vein anomalies in a Nigerian pediatric kidney transplant recipient: A case report and literature review

The finding of bilateral congenital common iliac vein anomalies is indeed uncommon. This article presents the case of an 11-year-old boy with end-stage renal disease who had kidney transplantation (KT). At presentation, he was found to have a large superficial vein running from the left groin over the suprapubic area. The arterial pulsation of both lower limbs was preserved, and there was no pedal edema. Contrast-enhanced computed tomography scan revealed aplasia of the right common iliac vein, stenosis of the left common iliac vein, and marked dilatation of the left external and internal iliac veins. There were also varicosity of numerous pelvic veins and a collateral vein draining the right lower limb. This preoperative diagnosis was key to planning for surgery. On KT surgery, the renal allograft vein was anastomosed in an end-to-side fashion to the inferior vena cava and artery to the common iliac artery. The patient had a smooth postoperative recovery and continues to enjoy a normal renal function.

Absence of right common iliac vein causing suprapubic and scrotal varices in a young athletic man

We have described the case of a 26-year-old man who had presented to his primary care physician with persistent, painful varices across his lower abdomen and bilateral tender scrotal varicoceles, which intensified with exercise. Thorough investigations revealed a congenitally atretic right common iliac vein with right-to-left collateralization of the femoral and internal iliac veins. This shunting resulted in the development of suprapubic and pelvic and gonadal varicosities, which provided a critical venous outflow pathway for his right lower extremity. Heightened vigilance is, hence, paramount if our patient requires future abdominal and urologic procedures. Moreover, the present case has highlighted the importance of considering deep system venous anomalies when determining the differential diagnosis for venous diseases.

Pelvic Lymphadenectomy in Gynecologic Oncology-Significance of Anatomical Variations

Pelvic lymphadenectomy is a common surgical procedure in gynecologic oncology. Pelvic lymph node dissection is performed for all types of gynecological malignancies to evaluate the extent of a disease and facilitate further treatment planning. Most studies examine the lymphatic spread, the prognostic, and therapeutic significance of the lymph nodes. However, there are very few studies describing the possible surgical approaches and the anatomical variations. Moreover, a correlation between anatomical variations and lymphadenectomy in the pelvic region has never been discussed in medical literature. The present article aims to expand the limited knowledge of the anatomical variations in the pelvis. Anatomical variations of the ureters, pelvic vessels, and nerves and their significance to pelvic lymphadenectomy are summarized, explained, and illustrated. Surgeons should be familiar with pelvic anatomy and its variations to safely perform a pelvic lymphadenectomy. Learning the proper lymphadenectomy technique relating to anatomical landmarks and variations may decrease morbidity and mortality. Furthermore, accurate description and analysis of the majority of pelvic anatomical variations may impact not only gynecological surgery, but also spinal surgery, urology, and orthopedics.

Absence of the Right Common Iliac Vein with the Right Internal Iliac Vein Arising from the Left Common Iliac Vein: Case Report

The common iliac vein arises from the internal and external iliac veins and drains into the inferior vena cava, bilaterally. Historically, many anatomical variants of the common iliac vein have been studied. To our knowledge, we discuss a unique specimen, which presents with an absent right common iliac vein and a right internal iliac vein draining into the contralateral common iliac vein. It is important that we understand the anatomic variations of the pelvic venous system to prevent iatrogenic injury to patients or misdiagnosis.

Dangerous twisted communications between external and internal iliac veins which might rupture during catheterization

In this report, four unusual communications between external and internal iliac veins of the left side have been presented. The lowest communication was the narrowest measuring about 2 mm in diameter, the second measured 6 mm, the third had a diameter of 7 mm and the last communication measured 5 mm in breadth. The upper three communications were twisted in a helical manner. The internal iliac vein had its normal tributaries except that the iliolumbar vein drained into the external iliac vein at the level of the third communication. The external iliac vein was slightly dilated just below the level of lowest communication.

Prearterial external iliac vein as a rare anomaly of the iliac vein

The coexistence of a retroperitoneal venous anomaly requires special consideration during open aortoiliac surgery. Anomalies of the external iliac vein are rare, and no anomalies of the right external iliac vein, which passes ventral to the external iliac artery, have been reported in the English literature to the best of our knowledge. We herein report the first case of Leriche syndrome combined with a prearterial external iliac vein treated with bypass surgery and a synthetic bifurcated graft.