Konishi M, Kikuchi M
Department of Oral Anatomy, School of Dentistry, Tohoku University, Sendai, Japan.
Kaibogaku Zasshi. 1991 Dec;66(6):524-36.
A case of persistent left superior vena cava with a horseshoe kidney was found in a Japanese male cadaver (72 years old) during a dissection for students in 1989. The main findings were as follows. The right superior vena cava (21.2 mm average diameter) was normal and opened into the right atrium. The left superior vena cava (8.4 mm average diameter) was smaller than the right one and ran in the coronary sinus to reach the right atrium. There was a small transverse anastomosis (8.9 mm average diameter), which corresponded to the normal left brachiocephalic vein, between the right and left superior vena cava. The azygos vein system showed a symmetrical condition and the right and left azygos veins opened into the superior vena cava on each side. This was the 57th case of persistent left superior vena cava reported in the anatomical literature in Japan. It corresponded to Type 3 of the classification by Fujimoto et al. (1971), and might be the first report of Type 3 in Japan. The horseshoe kidney was a typical one, in which the right and left kidneys were fused by an isthmus (bridge) consisting of renal tissues at their lower poles. The positions of both kidneys were lower than those of normal ones, the bilateral renal hili opened ventrally, the ureters ran on the anterior surface of the isthmus, the longitudinal axes of both kidneys crossed each other under the isthmus, and there were some additional renal arteries and veins. Neither the persistent left superior vena cava nor the horseshoe kidney alone are very rare anomalies, but a case such as the present, in which both anomalies coexist in the same body, is very rare.
1989年，在为学生进行解剖时，在一名72岁的日本男性尸体中发现了一例永存左上腔静脉合并马蹄肾的病例。主要发现如下。右上腔静脉（平均直径21.2mm）正常，开口于右心房。左上腔静脉（平均直径8.4mm）比右侧的小，走行于冠状窦内并到达右心房。在右上腔静脉和左上腔静脉之间有一个小的横向吻合支（平均直径8.9mm），相当于正常的左头臂静脉。奇静脉系统呈对称状态，左右奇静脉分别开口于两侧的上腔静脉。这是日本解剖学文献中报道的第57例永存左上腔静脉病例。它符合藤本等人（1971年）分类中的3型，可能是日本首例3型报道。马蹄肾是典型的，左右肾在下极由肾组织构成的峡部（桥）融合。两肾位置均低于正常，双侧肾门向前开口，输尿管走行于峡部前方，两肾长轴在峡部下交叉，并有一些额外的肾动脉和静脉。单纯的永存左上腔静脉或马蹄肾都不是非常罕见的异常，但像本例这样两种异常同时存在于同一机体的情况非常罕见。
