Abstract
We report herein the cases of two patients with major venous anomalies associated with abdominal aneurysmectomy, one being an isolated left-sided vena cava and the other, a retroaortic left renal vein, and discuss the clinical significance of such anomalies. In the first patient, an isolated left-sided vena cava was correctly diagnosed preoperatively by contrast-enhanced computed tomography (CE-CT) and digital subtraction angiography (DSA) which revealed that the vena cava crossed the normal portion of the aorta and the right renal vein ran cephalad. In the second patient, a retroaortic left renal vein was also preoperatively diagnosed with CE-CT and DSA. In both patients, dissection was performed, taking care to avoid injury to anomalous venous tributaries, and graft replacement for abdominal aneurysm was successfully carried out. Thus, careful preoperative evaluations using such imaging techniques as CE-CT, DSA, and venographic studies, are important for establishing the presence of an associated venous anomaly preoperatively to ensure the success of abdominal aneurysmal surgery.
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Sarma KP (1966) Anomalous inferior vena cava — Anatomical and clinical. Br J Surg 53:600–602
Becker FF (1962) A singular left-sided inferior vena cava. Anat Rec 143:117–120
Millory FJ, Anson BJ, Cauldwell EW (1962) Variations in inferior caval veins and in their regional and lumbar communications. Surg Gynec Obstet 115:131–142
Bartle EJ, Pearce WH, Sun JH, Rutherford RB (1987) Inferior venous anomalies and aortic surgery: Avoiding vascular injury. J Vasc Surg 6:590–593
Brener BJ, Darling RC, Frederick PL, Linton RR (1974) Major venous anomalies complicating abdominal aortic surgery. Arch Surg 108:159–165
Sakakibara N, Murata S, Takenaka M, Fuzinaga Y (1987) A case report of the isolated left-sided inferior vena cava with abdominal aortic aneurysm (in Japanese with English abstract). Rinshou Houshasen (J Clin Radiol) 32:865–868
Ishibe R, Maruko M, Arikawa K, Tabata D, Masuda H, Furuzono K, Nishimura A (1990) A case report of abdominal aortic aneurysm complicated by left-sided inferior vena cava (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 91:782–784
Hioki M, Takei H, Masuda S, Iedokoro Y, Shoji T (1991) A successful case report of ruptured abdominal aortic aneurysm with isolated left-sided inferior vena cava (in Japanese with English abstract). Nippon Geka Gakkai Zasshi (J Jpn Surg Soc) 92:1524–1527
Masuda M, Takahara Y, Takeuchi S, Tanaka H, Nakagawa Y, Nakajima N (1993) A case report of abdominal aortic aneurysmectomy with isolated left-sided inferior vena cava (in Japanese with English abstract). Nippon Kekkan Geka Gakkai Zasshi (J Vasc Surg) 2:509–513
Dupont J (1971) Isolated left-sided vena cava and abdominal aortic aneurysm. Arch Surg 102:211–212
Davachi AA, Thomas J, Dale WA, Perry FA, Michael B (1965) Acute spontaneous rupture of an arteriosclerotic aneurysm into an isolated left-sided inferior vena cava. Am J Cardiol 115:416–418
Mansour MA, Rutherford RB, Metcalf RK, Pearce WH (1990) Spontaneous aorto-left renal vein fistula: The “abdominal pain, hematuria, silent left kidney” syndrome. Surgery 109:101–106
Thompson RW, Yee LF, Natuzzi ES, Stoney RJ (1993) Aorta-left renal vein fistula syndrome caused by rupture of a juxtarenal abdominal aortic aneurysm: Novel pathologic mechanism for a unique clinical entity. J Vasc Surg 18:310–315
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Nonami, Y., Yamasaki, M., Sato, K. et al. Two types of major venous anomalies associated with abdominal aneurysmectomy: A report of two cases. Surg Today 26, 940–944 (1996). https://doi.org/10.1007/BF00311802
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DOI: https://doi.org/10.1007/BF00311802