MyMedR

Fulltext Multiple renal arteries with an ascending upward renal Vein of the right kidney: a case report

Al-Shibli S.M.

International Medical Journal Malaysia, 2014;13(1):57-60.

MyJurnal

As it is known; the majority of the human subjects has two renal arteries arising from the abdominal aorta; each will supply one kidney but in 30% of individuals, certain variations can be found. Accessory renal arteries constitute the most common and clinically important of these variations. For our case report, we are presenting one of these different variations that can be found in the blood supply of the kidneys. During dissecting the abdomen of an approximately 65 years-old male cadaver, multiple variations were found. There were double right renal arteries with prehilar branching of the upper renal artery. We found also that the right renal vein ascended upwards obliquely before ending in the lateral aspect of the inferior vena cava. Variation in the renal vessels is relatively common, especially multiple renal arteries, and can go smoothly without any abnormalities with the function of the kidney, but in some situations like renal transplantations, vascular reconstructions, and various surgical and radiological diagnostic techniques, the study of the anatomy of these variations is of crucial importance to decrease the patient morbidity during surgical procedures.

Matched MeSH terms: Vena Cava, Inferior

Fulltext New concepts of hepatic amoebiasis

Balasegaram M

Ann Surg, 1972 Apr;175(4):528-34.

PMID: 4259839

Matched MeSH terms: Vena Cava, Inferior

Fulltext Renal angiomyolipoma with inferior vena caval involvement

Haritharan T, Sritharan S, Bhimji S

Med J Malaysia, 2006 Oct;61(4):493-5.

PMID: 17243531 MyJurnal

Renal angiomyolipomas are innocuous benign tumours which rarely behave aggressively. This is a case of a 48 year old Malay lady presenting with right sided abdominal pain associated with a large right sided abdominal mass. She was diagnosed with renal angiomyolipoma of the right kidney complicated by inferior vena caval tumour thrombosis. She successfully underwent a radical nephrectomy and inferior vena caval thrombectomy using cardiopulmonary bypass and deep hypothermic circulatory arrest.

Matched MeSH terms: Vena Cava, Inferior/pathology*; Vena Cava, Inferior/surgery

Fulltext Abdominal aorta and inferior vena cava thromboses in advanced stage of malignant fibrous histiocytoma

Faisham WI, Zulmi W, Ezane AM, Biswal BM

Med J Malaysia, 2005 Oct;60(4):495-7.

PMID: 16570715

Asymptomatic simultaneous thrombosis of abdominal aorta and inferior vena cava is a rare complication in advanced malignancy. We described an incidental finding of this clinical entity in our patient who presented with advance stage of malignant fibrous hystiocytoma of soft tissue and pathological fracture. The radiological evaluation with spiral computed tomography scan of abdominal aorta and inferior vena cava are presented and the subsequent management highlighted.

Matched MeSH terms: Vena Cava, Inferior/physiopathology*

Multiple subcutaneous puncture and stoma bag drainage for gross lower limb edema: a case report

Beng TS, Chin LE

J Palliat Med, 2010 Aug;13(8):1037-8.

PMID: 20712471 DOI: 10.1089/jpm.2009.0314

We present a case of gross lower limb edema in a 21-year-old man with an intra-abdominal malignant fibrous histiocytoma. He had a 1-month history of lower limb edema secondary to inferior vena caval obstruction. His edema failed to respond to a combination of diuretics, oral frusemide 40 mg daily and oral spironolactone 100 mg daily. Subcutaneous drainage of both lower limbs with butterfly needles was performed with minimal improvement. However, he gained significant symptomatic relief with multiple subcutaneous punctures and stoma bag drainage. A total of 12.8 L of serous fluid was drained with this simple and effective method. This is the first report of the use of this method.

Matched MeSH terms: Vena Cava, Inferior

Fulltext Ectopic inferior vena cava thrombus secondary to a tubo-ovarian abscess

Koh KS, Abdullah NA, Chong VH

Med J Malaysia, 2014 Dec;69(6):293-5.

PMID: 25934966

Inferior vena cava (IVC) thrombosis typically arises distally from a thrombophlebitic extension in the pelvis or the lower extremities. It may also occur from propagation of an ovarian vein thrombosis as a result of gynaecological disorders such as pelvic inflammatory disease, endometritis or from pelvic surgeries. In this report, we present an interesting case of a tubo-ovarian abscess with an ectopic IVC thrombus. The approach to management in such cases is also highlighted.

Matched MeSH terms: Vena Cava, Inferior

Giant urinary bladder with left scrotal swelling: An unusual presentation of chronic urinary retention

Nur Bazlaah B, Nabiha F, Khairuzi S, Amerdad D, Mohd Firdaus H, Ismayudin I

Med J Malaysia, 2020 11;75(6):736-737.

PMID: 33219187

Chronic Urinary Retention (CUR) can be either asymptomatic or associated with lower urinary tract symptoms. There has been no report of case of CUR presented with unilateral scrotal swelling. In the present report, a 69-year-old man came with an abdominal distension and left scrotal swelling. He was initially diagnosed with ascites secondary to a possible malignancy. A diagnosis was established after a computed tomography (CT) scan was done that revealed a giant bladder distension with volume of 10.1 litres. The left scrotal swelling was resolved after catheterization was carried out. There was a possibility that the patient had inferior vena cava obstruction secondary to the huge bladder.

Matched MeSH terms: Vena Cava, Inferior

Fulltext Transcatheter closure of patent ductus arteriosus and interruption of inferior vena cava with azygous continuation using an Amplatzer duct occluder II

Koh GT, Ai Mokthar S, Hamzah A, Kaur J

Ann Pediatr Cardiol, 2009 Jul;2(2):159-61.

PMID: 20808631 DOI: 10.4103/0974-2069.58320

We report a case of transcatheter closure of patent ductus arteriosus using the new Amplatzer duct occluder II in an adult patient with interrupted inferior vena cava with azygous continuation via the femoral artery approach.

Matched MeSH terms: Vena Cava, Inferior

Inferior vena cava occlusion and protein-losing enteropathy after liver transplantation in children

Lee WS, John P, McKiernan P, de Ville De Goyet J, Kelly DA

J Pediatr Gastroenterol Nutr, 2002 Apr;34(4):413-6.

PMID: 11930100

Matched MeSH terms: Vena Cava, Inferior/abnormalities*

Fulltext Triple right testicular veins and their variant termination and communications

Nayak SB, Kodimajalu Vasudeva S

Heliyon, 2020 Sep;6(9):e05014.

PMID: 32995649 DOI: 10.1016/j.heliyon.2020.e05014

Testicular veins are known to show many variations in their origin, course and termination. Some of their variations can lead to male sterility. We report a unique variation of right testicular vein here. Pampiniform plexus reduced to three testicular veins (medial, middle and lateral) at the deep inguinal ring on the right side. The medial vein terminated into the right renal vein, the middle vein terminated into the inferior vena cava above the level of right renal vein (close to the suprarenal gland) and the lateral vein terminated partly into the veins in the capsules of the kidney and partly into the veins under the diaphragm. The medial and middle testicular veins were connected through an oblique communicating vein. The middle and lateral testicular veins were also connected to each other through another oblique communicating vein. Knowledge of this case could be useful to radiologists, nephrologists and surgeons in general.

Matched MeSH terms: Vena Cava, Inferior

Oblique Retro-Aortic Left Renal Vein and its Clinical Importance

Bhagavath P, Nayak BS, Monteiro NP, Kumar GP

Kathmandu Univ Med J (KUMJ), 2016 7 18;13(52):369-71.

PMID: 27423291

Kidneys are the organs that remove the waste products of the metabolic activities. A smooth blood flow to the kidneys is essential to maintain their function. Abnormalities of the renal vasculature may result not only in impairing the renal function but can lead to conditions like varicocele. During an autopsy of an adult male, we observed renal vascular variations. The left renal vein had a retro-aortic course before its termination into the inferior vena cava. It was joined with the inferior vena cava at the level of inferior mesenteric artery with an acute angle. The left testicular vein joined the left renal vein with an acute angle. The right kidney was supplied by two renal arteries. The knowledge about retro-aortic course of the left renal vein may be important during renal transplantation. The oblique course of left renal vein and the termination of left testicular vein into it with an acute angle may increase the chances of left sided varicocele.

Matched MeSH terms: Vena Cava, Inferior

Fulltext Spontaneous internal ilio-iliac fistula in an elderly woman presenting as heart failure

Tan G, Abdullah B, Kunanayagam S

Biomed Imaging Interv J, 2006 Apr;2(2):e13.

PMID: 21614225 MyJurnal DOI: 10.2349/biij.2.2.e13

Acquired intra-abdominal arteriovenous fistulas (AVFs) are a rare disorder where the communication most commonly occurs between abdominal aorta and inferior vena cava. Ilio-iliac AVF has been reported previously, but is exceedingly rare. We present a case of spontaneous ilio-iliac AVF in an elderly woman who presented with symptoms of right heart failure where the diagnosis was not considered. The computed tomographic (CT) and angiographic features are described. The current status of management as well as a review of the literature is also presented.

Matched MeSH terms: Vena Cava, Inferior

Performance of emergency physicians in point-of-care echocardiography following limited training

Bustam A, Noor Azhar M, Singh Veriah R, Arumugam K, Loch A

Emerg Med J, 2014 May;31(5):369-73.

PMID: 23428721 DOI: 10.1136/emermed-2012-201789

OBJECTIVES: The aim of this study was to evaluate if emergency medicine trainees with a short duration of training in echocardiography could perform and interpret bedside-focused echocardiography reliably on emergency department patients.
METHODS: Following a web-based learning module and 3 h of proctored practical training, emergency medicine trainees were evaluated in technical and interpretative skills in estimating left ventricular function, detection of pericardial effusion and inferior vena cava (IVC) diameter measurements using bedside-focused echocardiography on emergency department patients. An inter-rater agreement analysis was performed between the trainees and a board-certified cardiologist.
RESULTS: 100 focused echocardiography examinations were performed by nine emergency medicine trainees. Agreement between the trainees and the cardiologist was 93% (K=0.79, 95% CI 0.773 to 0.842) for visual estimation of left ventricular function, 92.9% (K=0.80, 95% CI 0.636 to 0.882) for quantitative left ventricular ejection fraction by M-mode measurements, 98% (K=0.74, 95% CI 0.396 to 1.000) for the detection of pericardial effusion, and 64.2% (K=0.45, 95% CI 0.383 to 0.467) for IVC diameter assessment. The Bland-Altman limits of agreement for left ventricular function was -9.5% to 13.7%, and a Pearson's correlation yielded a value of 0.82 (p<0.0001, 95% CI 0.734 to 0.881). The trainees detected pericardial effusion with a sensitivity of 60%, specificity of 100%, positive predictive value of 100% and negative predictive value of 97.9%.
CONCLUSIONS: Emergency medicine trainees were found to be able to perform and interpret focused echocardiography reliably after a short duration of training.
Study site: Trauma and emergency department, University of Malaya Medical Centre, Kuala Lumpur

Matched MeSH terms: Vena Cava, Inferior/ultrasonography

Ultrasonographic Measurements of the Liver, Gallbladder Wall Thickness, Inferior Vena Cava, Portal Vein and Pancreas in an Urban Region, Malaysia

Khammas ASA, Mahmud R

J Med Ultrasound, 2020 10 01;29(1):26-31.

PMID: 34084713 DOI: 10.4103/JMU.JMU_53_20

Background: Ultrasonographic (USG) measurements of the liver length, gallbladder wall thickness (GBWT), diameters of the inferior vena cava (IVC), portal vein (PV), and pancreas are valuable and reliable in diagnosis hepatobiliary and pancreas conditions. This study is aimed to determine the normal values of liver length, GBWT, AP diameters of the IVC and PV, AP diameter of the head and body of the pancreas.

Methods: A prospective cross-sectional study was carried out in this study. A total of the 408 participants were randomly recruited using a systematic method. According to the USG reports, the subjects who had normal USG report for liver, biliary system, and pancreas were described as normals, whereas the subjects who had hepatobiliary diseases such as fatty liver, liver cysts, hemangioma, cirrhosis, gallbladder wall thickening, acute cholecystitis, gallstones, and polyps were recorded as abnormal subjects.

Results: Of the 408 participants with a mean of 52.6 ± 8.4 years old. Of those, 294 (72.1%) participants were normal and 114 (27.9%) subjects were reported as abnormal. More than half of the study population was males, 52.9% versus 47.1% of females. There was a significant difference of liver length, head, and body of the pancreas between genders (P = 0.004, 0.002, and P < 0.001, respectively). Moreover, the pancreatic body only was significantly correlated with age (P = 0.026). There also was a significant difference of the liver length, head, and body of the pancreas between normal and abnormal subjects (P < 0.001, P = 0.007, and P < 0.001).

Conclusion: Liver length, diameter of the head, and body of the pancreas were significantly associated with gender and hepatobiliary diseases. In addition, only the diameter of the body of the pancreas was significantly correlated with age.

Matched MeSH terms: Vena Cava, Inferior

Fulltext Ultrasonographic assessment of inferior vena cava/abdominal aorta diameter index: a new approach of assessing hypovolemic shock class 1

Rahman NH, Ahmad R, Kareem MM, Mohammed MI

Int J Emerg Med, 2016 Dec;9(1):8.

PMID: 26894896 DOI: 10.1186/s12245-016-0101-z

We designed this study to expand the usage of ultrasound to detect early occurrence of hypovolemia. We explore the potential use of inferior vena cava (IVC) and abdominal aorta (AA) diameter index (IVC:AA) measured ultrasonographically to detect class 1 hypovolemic shock with blood loss less than 15%.ᅟ

Matched MeSH terms: Vena Cava, Inferior

Fulltext Inferior vena cava tumour thrombectomy by novel endovascular approach

Shahril, K., Reynu, R., Kosai, N.R., Bong, J.J., Rozman, Z., Yazmin, Y., et al.

Medicine & Health, 2015;10(2):151-155.

MyJurnal

The presence of thrombus within the inferior vena cava (IVC) is often a sign of advance hepatocellular carcinoma (HCC). Various treatment methods have been described with variable and inconclusive results. Now, the advancement of endovascular approach offers new possibility as a potential treatment modality. We discuss the removal of tumour thrombus with catheter directed mechanical thrombectomy. IVC tumour secondary HCC was removed by AngioJet® rheolytic system (Possis Medical, Minneapolis, MN, USA) with good result. Further work should be encouraged to explore the prospect of this technique with other treatment modalities.

Matched MeSH terms: Vena Cava, Inferior

Fulltext Azygos continuation of the inferior vena cava in carcinoma of oesophagus.

Mubarak, M.Y.

International Medical Journal Malaysia, 2008;7(2):57-61.

MyJurnal

The azygos system enlarges in cases of obstruction to the superior vena cava or inferior vena cava and result in increase blood flow through the system. Azygos continuation of the inferior vena cava is usually congenital and asymptomatic. The azygos vein is the sole drainage of the blood from the lower half of the body to the heart. It is crucial to identify the anomaly as it might involve in the surgical planning of tumours in the thorax or abdomen. Computed Tomography is a non-invasive technique and provide important information about the tumour and the vascular anomaly.

Matched MeSH terms: Vena Cava, Inferior

Fulltext An uncommon and insidious presentation of renal cell carcinoma with tumor extending into the inferior vena cava and right atrium: a case report

Lu HT, Chong JL, Othman N, Vendargon S, Omar S

J Med Case Rep, 2016 May 03;10(1):109.

PMID: 27142514 DOI: 10.1186/s13256-016-0888-5

BACKGROUND: Renal cell carcinoma is a potentially lethal cancer with aggressive behavior and it tends to metastasize. Renal cell carcinoma involves the inferior vena cava in approximately 15% of cases and it rarely extends into the right atrium. A majority of renal cell carcinoma are detected as incidental findings on imaging studies obtained for unrelated reasons. At presentation, nearly 25% of patients either have distant metastases or significant local-regional disease with no symptoms that can be attributed to renal cell carcinoma.

CASE PRESENTATION: A 64-year-old Indian male with a past history of coronary artery bypass graft surgery, congestive heart failure, and diabetes mellitus complained of worsening shortness of breath for 2 weeks. Incidentally, a transthoracic echocardiography showed a "thumb-like" mass in his right atrium extending into his right ventricle through the tricuspid valve with each systole. Abdomen magnetic resonance imaging revealed a heterogenous lobulated mass in the upper and mid-pole of his right kidney with a tumor extending into his inferior vena cava and right atrium, consistent with our diagnosis of advanced renal cell carcinoma which was later confirmed by surgical excision and histology. Radical right nephrectomy, lymph nodes clearance, inferior vena cava cavatomy, and complete tumor thrombectomy were performed successfully. Perioperatively, he did not require cardiopulmonary bypass or deep hypothermic circulatory arrest. He had no recurrence during the follow-up period for more than 2 years after surgery.

CONCLUSIONS: Advanced extension of renal cell carcinoma can occur with no apparent symptoms and be detected incidentally. In rare circumstances, atypical presentation of renal cell carcinoma should be considered in a patient presenting with right atrial mass detected by echocardiography. Renal cell carcinoma with inferior vena cava and right atrium extension is a complex surgical challenge, but excellent results can be obtained with proper patient selection, meticulous surgical techniques, and close perioperative patient care.

Matched MeSH terms: Vena Cava, Inferior/surgery

Fulltext Extra-adrenal paraganglioma: presentation in three uncommon locations

Mun KS, Pailoor J, Chan KS, Pillay B

Malays J Pathol, 2009 Jun;31(1):57-61.

PMID: 19694315 MyJurnal

Extra-adrenal paragangliomata are uncommon entities. They can be classified into four basic groups according to their anatomical sites, i.e. branchiomeric, intravagal, aorticosympathetic and visceral autonomic. Similar tumours may arise in sites away from the usual distribution of the sympathetic and parasympathetic ganglia, e.g. orbit, nose, small intestine and even in the pancreas. We report three instructive cases of extra-adrenal paraganglioma which were found in unusual sites such as urinary bladder, thyroid gland and on the wall of the inferior vena cava.

Matched MeSH terms: Vena Cava, Inferior/metabolism; Vena Cava, Inferior/pathology*; Vena Cava, Inferior/surgery

Fulltext Metastatic Adenocarcinoma Presenting as Extensive Cavoatrial Tumor Thrombus

Johari B, Abdul Aziz YF, Krishnasamy S, Looi LM, Hashim SA, Raja Mokhtar RA

Iran J Radiol, 2015 Apr;12(2):e11197.

PMID: 26060549 DOI: 10.5812/iranjradiol.11197

The presence of tumor thrombus in the right atrium is frequently the result of direct intraluminal extension of infra-diaphragmatic malignancy into the inferior vena cava (IVC) or supradiaphragmatic carcinoma into the superior vena cava (SVC). Right atrial tumor thrombus with extension into both SVC and IVC has not been reported in the literature. We present a patient who presented with symptoms of right atrial and SVC obstruction. Imaging revealed presence of a thrombus in the right atrium, extending to the SVC and IVC, with the additional findings of a left adrenal mass and multiple liver lesions. The histopathological examination of the right atrial mass revealed metastatic adenocarcinoma cells. The patient was given a presumptive diagnosis of metastatic adenocarcinoma, most likely adrenal in origin, with multiple hepatic lesions suspicious for metastasis. The clinical outcome of the patient was not favorable; the patient succumbed before the adrenal mass could be confirmed to be the primary tumor. This case highlights that in patients manifesting with extensive cavoatrial thrombus as, the existence of primary carcinoma should be considered especially in the adrenal cortex or in the lung.

Matched MeSH terms: Vena Cava, Inferior

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