Duplication of the inferior vena cava : evidence of a novel type IV

Anatomical variations of the inferior vena cava, including the double inferior vena cava or isolated left inferior vena cava, are uncommon and of great clinical importance. Inferior vena cava variations signify predisposition to deep vein thrombosis and may complicate retroperitoneal surgeries including abdominal aortic surgery. Failure to recognize such variations may predispose a patient to life- threatening complications. This prospective anatomical study assessed 129 cadavers for variations of the inferior vena cava. One of the 129 cadavers (0.78%) possessed a double inferior vena cava and none (0%) possessed an isolated left inferior vena cava. The left-sided inferior vena cava was of a larger diameter than that of the right-sided inferior vena cava - opposite of what would be seen in a Type III duplication. Therefore, this observation expands the three-type classification system to include a Type IV duplication

Dilemmas in anticoagulation and use of inferior vena cava filters in venous thromboembolism; A survey of respiratory physicians, haematologists and medical oncologists and a review of the literature

© The Author(s) 2021. Twenty percent of patients with Cancer Associated Thrombosis receive an inferior vena cava filter annually. Insertion is guided by practice guidelines, which do not specify or discuss the use of inferior vena cava filters in malignancy. Adherence to these guidelines is known to be variable. We aimed to see if there was consistent management of venous thromboembolism among Medical Oncologists/Haematologists and Respiratory Physicians, with respect to inferior vena cava filter use in the setting of suspected and confirmed malignancy. Medical Oncologists, Haematologists and Respiratory Physicians were surveyed with four theoretical cases. Case 1 concerns a patient who develops a pulmonary embolism following spinal surgery. Cases 2 and 4 explore the use of inferior vena cava filters in the setting of malignancy. Case 3 covers the role of inferior vena cava filters in recurrent thrombosis despite systemic anticoagulation. There were 56 responses, 32 (57%) Respiratory Physicians and 24 (43%) Haematologists/Oncologists. Respiratory Physicians were significantly more likely to insert an inferior vena cava filter in case 1 (p = 0.04) whilst Haematologists/Medical Oncologists were more likely to insert an inferior vena cava filter in case 3 (p = 0.03). No significant differences were found in cases 2 and 4. There were significant disparities in terms of type and timing of anticoagulation. Consistency of recommendations with guidelines was variable likely in part because guidelines are themselves inconsistent. The heterogeneity in responses highlights the variations in venous thromboembolism management, especially in Cancer Associated Thrombosis. International Societies should consider addressing inferior vena cava filter use specifically in the setting of Cancer Associated Thrombosis. Collaboration between interested specialities would assist in developing consistent, evidence-based guidelines for the use of inferior vena cava filters in the management of venous thromboembolism

The reverse portacaval shunt

A technique has been described in which all the venous drainage of the deep femoral system is diverted through the hepatic bed by means of a reverse Eck fistula and systematic division of collaterals from the inferior vena cava and iliac veins. The use of this technique in the study of liver metabolism is proposed. Employment of simple reverse Eck fistula is suggested in clinical situations in which there is subdiaphragmatic destruction of the inferior vena cava. © 1959

Inferior vena cava injury: survival of a rare case

The inferior vena cava is the most commonly injured abdominal vessel and accounts for about 25% of abdominal vascular injuries. Despite improved preoperative care and operative techniques, the mortality rates for the inferior vena cava injuries are still high due to delayed presentation, inadequate or delayed fluid resuscitation, difficulty of diagnosis and technical problems in repair. A case of the inferior vena cava injury encountered after abdominal stabinjury with about 4cm vertical tear of infrarenal vena cava, survived due to immediate transportation, appropriate and successful perioperative fluid and blood resuscitation, prompt surgical management with a team approach and critical post-operative surgical management.Keywords: The inferior vena cava (IVC), stab wound, venorrhaphy, haemoperitoneu

Duodenal Perforation due to Inferior Vena Cava Filter in a Multi-morbid Young Patient: First Clinical Case Report in Latvia

ABSTRACT Introduction: The inferior vena cava filter is known to be a safe and effective method for preventing fatal pulmonary artery thromboembolism. We report a case report of inferior vena cava filter perforation on duodenum in a multimorbid young patient undergoing full midline laparotomy and cavotomy. Case presentation: A 37-year-old male was admitted to a tertiary university hospital following recurrent episodes of epistaxis. In 2008, the patient developed traumatic subarachnoid haemorrhage with a following decompressive trepanation and bilateral pulmonary artery thromboembolism. An inferior vena cava filter was implanted. In 2021, due to suspected duodenal perforation, an urgent fibrogastroscopy was performed, revealing duodenal perforation caused by the inferior vena cava filter and aortic pseudoaneurysm. Vena cava filter evacuation was indicated; to date, no such operation has been performed in Latvia. The early postoperative period occurred without any complications. The patient was discharged 15 days after the surgical treatment in good overall health. Results: This was a clinical case report about a 37-year-old multimorbid patient with positive anamnesis of traumatic subarachnoid haemorrhage following decompressive trepanation and bilateral pulmonary artery thromboembolism and inferior vena cava filter implantation due to absolute contraindications to anticoagulant therapy. Conclusion: Inferior vena cava filters are generally safe but can cause clinically significant complications. The case of 37-year-old multimorbid patient with the main complaints of pain around the left ear and recurrent nose bleeds was discussed. On fibrogastroscopy, duodenal perforation caused by the inferior vena cava filter and aortic pseudoaneurysm were seen. Full midline laparotomy and cavotomy was performed. The patient was discharged in good overall health. Detailed assessment of the radiological findings, fibrogastroscopic studies and the novel treatment of a complicated disease occurring for the first time in Latvia proved successful for both patient recovery and outcome. Keywords: Cavotomy; Laparotomy; Multimorbidity; Inferior vena cava filter; Duodenal perforationpublishersversionPeer reviewe

Leiomyosarcoma of the inferior vena cava: a case report and review of the literature

A 68-year-old white female presented with two years of progressively worsening dyspnea. Echocardiography revealed a large right atrial mass and partial obstruction of the inferior vena cava. Further imaging revealed a cystic dense mass in the inferior vena cava and right atrium. Immunohistochemical stains were consistent with leiomyosarcoma. Intraoperatively, the tumor was noted to originate from the posterior aspect of the inferior vena cava. The patient underwent successful resection of the mass. Adjuvant radiation therapy was completed. The patient's dyspnea gradually improved and she continues to remain disease free five years post-resection

A case of leiomyosarcoma of the inferior vena cava

A case of primary leiomyosarcoma of the inferior vena cava was reported. The patient, a 74-year-old man, consulted our hospital with complaints of back pain and abdominal mass in right flank. Probe laparotomy revealed a tumor situated in the retroperitoneum and multiple metastatic nodules in the liver. Biopsy was performed and diagnosed as leiomyosarcoma. He was intensively treated with antineoplastic chemotherapy, but his condition gradually aggravated. He died 4 months after admission. The autopsy revealed a right retroperitoneal mass (17 X 12 X 18 cm in size, 1, 340 g in weight) that showed a yellowish appearance. There was also a thumb-tip sized tumor with a stalk in the lumen of inferior vena cava. Both tumors grew in continuity with each other through the wall of inferior vena cava. The tumors were diagnosed as leiomyosarcoma, which derived from inferior vena cava

The Relationship between Inferior Vena Cava Distensibility and Arterial Blood Pressure

The purpose of this study was to clarify the relationship between the inferior vena cava distensibility and blood pressure. Six Japanese healthy males volunteered to participate in this study. We measured the cross-sectional area of inferior vena cava (CSAivc) and blood pressure at rest and during passive leg raising in supine position. We calculated the change rates of each parameter, based on the value at rest in supine position. We observed a negative correlation between the change rate of CSAivc and systolic blood pressure (P<0.05). These results suggest that the inferior vena cava distensibility affects partially systolic blood pressure

An interrupted inferior vena cava in a situs inversus: a case report and review of the literature

Situs inversus with interrupted inferior vena cava is an uncommon anatomic variant found in the abdominal and thoracic viscera. In this report, we present a 59-year-old woman with this variation, found during gross anatomical dissection. While this type of variation has been variable, in the present case the hepatic veins drained directly into a very short (2.2 cm) inferior vena cava. The infrarenal component of the inferior vena cava was present and drained into the azygos and hemiazygos veins. Clinical considerations of this variant anatomy are of interest, as they may present in patients as pathology on cross sectional imaging

Bilateral pyogenic psoas abscesses with inferior vena cava thrombosis.

Psoas abscess is a rare clinical entity. Rarely, it is associated with thrombosis of the inferior vena cava. This report is of a 36-year-old woman with bilateral pyogenic psoas abscesses with spondylodiscitis complicated by thrombosis of the inferior vena cava. The pathogenesis and imaging features of this condition are discussed