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Abstract
The inferior vena cava (IVC) is the largest vein in the body, draining blood from the abdomen, pelvis and lower extremities. This pictorial review summarises normal anatomy and embryological development of the IVC. In addition, we highlight a wide range of anatomical variants, acquired pathologies and a common pitfall in imaging of the IVC. This information is essential for clinical decision making and to reduce misdiagnosis.
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Affiliation(s)
- Simon J Li
- Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
| | - Jean Lee
- Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia
| | - Jonathan Hall
- Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.,Department of Radiology, Austin Health, Heidelberg, VIC, Australia
| | - Tom R Sutherland
- Medical Imaging Department, St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.,Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia
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2
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Nigro B, Ferrari Ayarragaray JE. Inferior vena cava anomalies: review and surgical considerations. Angiologia 2021. [DOI: 10.20960/angiologia.00282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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3
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Abstract
Background: Evaluation of renal vascular variations is important in renal donors to avoid vascular complications during surgery. Venous variations, mainly resulting from the errors of the embryological development, are frequently observed. Aim: This retrospective cross-sectional study aimed to investigate the renal vascular variants with multidetector computed tomography (MDCT) angiography to provide valuable information for surgery and its correlations with surgical findings. Materials and Methods: A total of 200 patients underwent MDCT angiography as a routine work up for live renal donors. The number, course, and drainage patterns of the renal veins were retrospectively observed from the scans. Anomalies of renal veins and inferior vena cava (IVC) were recorded and classified. Multiplanar reformations (MPRs), maximum intensity projections, and volume rendering were used for analysis. The results obtained were correlated surgically. Results: In the present study, out of 200 healthy donors, the standard pattern of drainage of renal veins was observed in only 67% of donors on the right side and 92% of donors on the left side. Supernumerary renal veins in the form of dual and triple renal veins were seen on the right side in about 32.5% of donors (dual right renal veins in 30.5% cases and triple right renal veins in 2.5% cases). Variations on the left side were classified into four groups: supernumerary, retro-aortic, circumaortic, and plexiform left renal veins in 1%, 2.5%, 4%, 0.5%, cases respectively. Conclusions: Developmental variations in renal veins can be easily detected on computed tomography scan, which can go unnoticed and can pose a fatal threat during major surgeries such as donor nephrectomies in otherwise healthy donors if undiagnosed.
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Affiliation(s)
- Vaidehi Kumudchandra Pandya
- Department of Radio Diagnosis and Imaging, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | | | - Harsh Chandrakant Sutariya
- Department of Radio Diagnosis and Imaging, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
| | - Shruti Pradipkumar Gandhi
- Department of Radio Diagnosis and Imaging, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India
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Ichikawa T, Kawada S, Koizumi J, Endo J, Itou C, Matsuura K, Terachi T, Imai Y. Anomalous inferior vena cava associated with horseshoe kidney on multidetector computed tomography. Clin Imaging 2013; 37:889-94. [PMID: 23849103 DOI: 10.1016/j.clinimag.2013.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Revised: 01/31/2013] [Accepted: 03/21/2013] [Indexed: 11/16/2022]
Abstract
We evaluated the prevalence of anomalous inferior vena cava (IVC) associated with 205 patients with horseshoe kidney (HSK) and 1990 patients without HSK on multidetector computed tomography and compared prevalence between both groups. We identified anatomical variations of the IVC in 8 patients (3.9%) with HSK (1 preisthmic IVC with retrocaval ureter, 4 double IVCs, 2 left IVCs, and 1 IVC with azygos continuation) and in 12 patients (0.6%) without HSK (8 double IVCs, 3 left IVCs, and 1 IVC with azygos continuation). Anomalous IVC was significantly more frequent in patients with HSK than those without it.
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Affiliation(s)
- Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine, Isehara, Kanagawa 159-1193, Japan.
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Iimura A, Oguchi T, Shibata M, Matsuo M, Takahashi Y, Takahashi T. Morphological observation of the horseshoe kidney with circumaortic venous ring. Okajimas Folia Anat Jpn 2013; 89:67-74. [PMID: 23429051 DOI: 10.2535/ofaj.89.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In a student course of gross anatomy dissection at Knagawa Dental College in 2010, we found an extremely rare case of the horseshoe kidney with circumaortic venous ring in a 43-year-old Japanese male cadaver. In this case, the kidney consisted of three parts: the original kidneys on both sides and an isthmus between them. The location of each kidney was lower than that of the normal kidney. The hili on both sides opened toward the ventral direction, and the ureters descended in front of the isthmus and entered the bladder normally. This horseshoe kidney had original left and right renal arteries that branched from the abdominal aorta. There were also two surplus arteries. There were three renal veins on the left side, and these renal veins formed the circumaortic venous ring. The anatomical and embryological significance of this anomaly and its associated vascular system are discussed. The anatomy and etiology of these anomalous structures are discussed with references in the literature.
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Affiliation(s)
- Akira Iimura
- Department of Anatomy, Kanagawa Dental College, Yokosuka, Kanagawa 238-8580, Japan.
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Ichikawa T, Sekiguchi T, Kawada S, Koizumi J, Endo J, Yamada Y, Ito C, Sugiyama M, Terachi T, Usui Y, Torigoe K, Imai Y. Study of the Association Between an Anomalous Superior Vena Cava and Horseshoe Kidney. Circ J 2012; 76:1253-8. [DOI: 10.1253/circj.cj-11-0874] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine
| | | | - Shuichi Kawada
- Department of Radiology, Tokai University School of Medicine
| | - Jun Koizumi
- Department of Radiology, Tokai University School of Medicine
| | - Jun Endo
- Department of Radiology, Tokai University School of Medicine
| | - Yuri Yamada
- Department of Radiology, Tokai University School of Medicine
| | - Chihiro Ito
- Department of Radiology, Tokai University School of Medicine
| | - Makoto Sugiyama
- Department of Radiological Technology, Tokai University School of Medicine
| | | | - Yukio Usui
- Department of Urology, Tokai University School of Medicine
| | - Kojun Torigoe
- Department of Anatomy, Tokai University School of Medicine
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine
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Broholm R, Jørgensen M, Just S, Jensen LP, Bækgaard N. Acute Iliofemoral Venous Thrombosis in Patients with Atresia of the Inferior Vena Cava Can Be Treated Successfully with Catheter-directed Thrombolysis. J Vasc Interv Radiol 2011; 22:801-5. [DOI: 10.1016/j.jvir.2011.01.449] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 01/11/2011] [Accepted: 01/26/2011] [Indexed: 11/29/2022] Open
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Ichikawa T, Kawada S, Koizumi J, Endo J, Iino M, Terachi T, Usui Y, Nishibe T, Dardik A, Imai Y. Major Venous Anomalies Are Frequently Associated With Horseshoe Kidneys - Value of Multidetector Computed Tomography -. Circ J 2011; 75:2872-7. [DOI: 10.1253/circj.cj-11-0613] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Tamaki Ichikawa
- Department of Radiology, Tokai University School of Medicine
| | - Shuichi Kawada
- Department of Radiology, Tokai University School of Medicine
| | - Jun Koizumi
- Department of Radiology, Tokai University School of Medicine
| | - Jun Endo
- Department of Radiology, Tokai University School of Medicine
| | - Misako Iino
- Department of Radiology, Tokai University School of Medicine
| | | | - Yukio Usui
- Department of Urology, Tokai University School of Medicine
| | | | - Alan Dardik
- Department of Vascular Surgery, Yale University School of Medicine
| | - Yutaka Imai
- Department of Radiology, Tokai University School of Medicine
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Oktem H, Gozil R, Calguner E, Bahcelioglu M, Mutlu S, Kurkcuoglu A, Yucel D, Senol E, Babus T, Kadioglu D. Morphometric study of a horseshoe kidney. Med Princ Pract 2008; 17:80-3. [PMID: 18059107 DOI: 10.1159/000109596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2006] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To describe a horseshoe kidney, a congenital anomaly of the upper urinary tract. CLINICAL PRESENTATION A case study of horseshoe kidney harvested from a 62-year-old cadaver at Gazi University Medical School is presented. RESULTS The right and left kidneys were fused at their lower poles by a parenchymal isthmus located ventral to the abdominal aorta and formed a U-shape with two unequal arms. The isthmus of the ectopic kidney was placed obliquely to the left at the level of the fourth and fifth lumbar vertebra. The left kidney was larger and longer than the right one. The kidneys were supplied by three renal arteries arising from the abdominal aorta. Two arteries on the right side supplied blood of the two kidneys, while the third artery that directly originated from the aorta, above the origin of inferior mesenteric artery, supplied the isthmus. Venous drainage of the both kidneys and the isthmus were drained by three veins that opened independently into the inferior vena cava. The right ureter was duplicated in origin. CONCLUSION This report shows that knowledge of anomalies such as this is very important in planning and conducting surgical procedures.
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Affiliation(s)
- Hale Oktem
- Department of Anatomy, School of Medicine, University of Gazi, Ankara, Turkey
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Davari HR, Malek-Hosseini SA, Salahi H, Bahador A, Nikeghbalian S, Jalaeian H, Salehipour M, Roozbeh J, Rais-Jalali G, Sagheb MM, Kazemi K, Nejatollahi SMR. Management of infrarenal duplicated inferior vena cava during living related kidney transplantation. Transpl Int 2007; 20:478-9. [PMID: 17263785 DOI: 10.1111/j.1432-2277.2007.00456.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
The finding of an untreated omphalocele in adulthood is extremely rare. We report the case of a 29-year-old patient, who presented to us with a congenital defect of the abdominal wall and protrusion of underlying viscera.
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Abstract
Anomalies of the inferior vena cava and renal veins occur infrequently but if unidentified can lead to significant morbidity during surgical exploration. An understanding of the embryologic development of the vena cava and its tributaries is necessary to understand the genesis of these sometimes complex anomalies and their accompanying anatomic variants. Newer radiologic modalities in the form of spiral computed tomography (CT) and three-dimensional reconstruction of spiral CT allow clear definition of the anatomy of these anomalies. Variations in the embryologic evolution of the vena cava dictate the different venous anomalies that may be encountered in the retroperitoneum. Additionally, the utility of newer radiologic modalities in the identification of these anomalies is discussed.
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Affiliation(s)
- R Mathews
- James Buchanan Brady Urological Institute and Russell H. Morgan Department of Radiology and Radiologic Science, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA
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