Itoh M, Moriyama H, Tokunaga Y, Miyamoto K, Nagata W, Satriotomo I, Shimada K, Takeuchi Y
Department of Anatomy, Kagawa Medical University, Kagawa, Japan.
Int J Androl. 2001 Jun;24(3):142-52. doi: 10.1046/j.1365-2605.2001.00286.x.
The right gonadal vein (GV=testicular vein in men, ovarian vein in women) usually drains into the inferior vena cava (IVC) while the left gonadal vein drains into the left renal vein (RV). This anatomical difference induces relatively weak haemodynamics in the left testicular vein (TV) and is considered to be a cause of a left varicocele. In textbooks on embryology, it has been documented that bilateral supracardinal veins (=origin of right and left IVC) and the subcardinal sinus (=origin of RVs and GVs) symmetrically develop during early embryogenesis. However, persistence and regression of the right and left supracardinal veins, respectively, results in drainage of the left GV into the ipsilateral RV. A double IVC (DIVC) commonly originates from a failure of disappearance of the left supracardinal vein. Although there have been a considerable number of case reports on DIVC, little attention has been paid to the anatomy of the left GV in such cases. We report here an autopsy case, a 72-year-old Japanese man, with a DIVC. This case belongs to type BC of McClure and Butler's classification. In this case, it was observed that the right TV drained into the confluence of the right IVC with the ipsilateral RV, while the left TV drained into the left RV in spite of the presence of the left IVC. This case indicates that the embryonic anastomosis point between the subcardinal sinus and the supracardinal vein on the left side is different from that on the right side. Statistical analysis of many case reports of DIVC also suggests that the bilateral supracardinal veins tend to asymmetrically anastomose with the subcardinal sinus during embryogenesis. These data imply that drainage of the left GV into the ipsilateral RV leads to regression of the left supracardinal vein but also to asymmetrical anastomosis between the supracardinal veins and the subcardinal sinus.
右侧性腺静脉（男性为睾丸静脉，女性为卵巢静脉）通常汇入下腔静脉，而左侧性腺静脉则汇入左肾静脉。这种解剖学差异导致左侧睾丸静脉的血流动力学相对较弱，被认为是左侧精索静脉曲张的一个原因。在胚胎学教科书中，有记载称双侧上心静脉（即左右下腔静脉的起源）和下心窦（即肾静脉和性腺静脉的起源）在胚胎早期发育过程中对称发育。然而，左右上心静脉分别持续存在和退化，导致左侧性腺静脉汇入同侧肾静脉。双下腔静脉通常源于左侧上心静脉未消失。尽管有大量关于双下腔静脉的病例报告，但此类病例中左侧性腺静脉的解剖结构很少受到关注。我们在此报告一例尸检病例，一名72岁的日本男性，患有双下腔静脉。该病例属于麦克卢尔和巴特勒分类中的BC型。在该病例中，观察到右侧睾丸静脉汇入右侧下腔静脉与同侧肾静脉的汇合处，而左侧睾丸静脉尽管存在左侧下腔静脉，但仍汇入左肾静脉。该病例表明，左侧下心窦与上心静脉之间的胚胎吻合点与右侧不同。对许多双下腔静脉病例报告的统计分析也表明，在胚胎发育过程中，双侧上心静脉倾向于与下心窦不对称吻合。这些数据表明，左侧性腺静脉汇入同侧肾静脉不仅导致左侧上心静脉退化，还导致上心静脉与下心窦之间的不对称吻合。
