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器官获取手术中发现左侧下腔静脉:两例报告

Left-Sided Inferior Vena Cava Encountered During Organ Retrieval Surgery: Report of Two Cases.

作者信息

Rajabnejad Y, Aliakbarian M, Rajabnejad A, Motie M R

机构信息

Surgical Oncology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Int J Organ Transplant Med. 2016;7(4):229-232. Epub 2016 Nov 1.

Abstract

Left-sided inferior vena cava (IVC) is the second most common anatomical anomaly of the IVC after duplication. Herein, we present two cases of left-sided IVC, diagnosed during organ retrieval procedure. In a young brain-dead man, a single left-sided IVC was observed; it originated from iliac confluence in the left side of the aorta and extended throughout the abdomen. There was no retrohepatic IVC in the patient; hepatic veins drained directly into the right atrium. The second case was a brain-dead young woman with a left-sided IVC originated from iliac confluence to the kidney level; then, the IVC crossed anterior to the abdominal aorta to join a normally positioned retrohepatic IVC. In cases of retroperitoneal surgeries, IVC anomalies should be considered during preoperative imaging studies, because they may be misdiagnosed as para-aortic lymphadenopathy, tumor or dilated gonadal vein that may result in iatrogenic damage during surgery.

摘要

左侧下腔静脉(IVC)是继重复畸形后第二常见的下腔静脉解剖异常。在此,我们呈现两例在器官获取过程中诊断出的左侧下腔静脉病例。在一名年轻的脑死亡男性中,观察到单一的左侧下腔静脉;它起源于主动脉左侧的髂总静脉汇合处,并延伸至整个腹部。该患者无肝后段下腔静脉;肝静脉直接汇入右心房。第二例是一名脑死亡的年轻女性,其左侧下腔静脉起源于髂总静脉汇合处至肾水平;然后,下腔静脉在腹主动脉前方交叉,与正常位置的肝后段下腔静脉汇合。在腹膜后手术中,术前影像学检查时应考虑下腔静脉异常,因为它们可能被误诊为主动脉旁淋巴结病、肿瘤或扩张的性腺静脉,这可能在手术期间导致医源性损伤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23b6/5219584/942e43f3dcc1/ijotm-7-229-g001.jpg

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