左、右髂总静脉高位汇合形成下腔静脉变异1例

教学发现一例左、右髂总静脉高位汇合形成下腔静脉,其变异对影像诊断及临床治疗具有一定的参考意义,为积累形态学资料,现报导如下。变异标本为成年男性,身高155 cm。腹腔解剖见左髂内、外静脉于左髂内、外动脉分叉处下方约2 cm处汇合,形成左髂总静脉,直径2·4 cm。左髂总静脉与     

右髂总动脉弯曲畸形一例报道

<正>笔者在解剖一具40岁男性尸体标本时,发现其右侧髂总动脉有弯曲畸形,现报道如下。成尸发育正常,双下肢对称等粗。动脉弯曲畸形有一处,为右髂总动脉跨越左、右髂总静脉分叉处。左侧髂总动脉主干及左、右髂总动脉的分支无异常。畸形中点距离右髂总动脉根部约8.8 cm,距离肠系膜下动脉根部约15.8 cm,距离右髂内动脉和髂外动     

闭孔动脉起源于髂外动脉变异1例

作者在局部解剖教学中,见一成年男性标本左侧闭孔血管动脉起源于髂外动脉(图1),为积累资料及为临床提供参考,现报道如下: 左侧闭孔动脉于腹股沟韧带中点上方2 cm处自左髂外动脉内侧壁发出,向内下跨耻骨支伴正常来源的闭孔神经进入闭膜管.     

髂内、外静脉的观测及骶外侧静脉与闭孔静脉的应用解剖

盆部静脉对某些疾病的诊断治疗,具有重要意义.我们在教学实地解剖中发现,这些静脉的解剖与教科书中的记述,颇有差异.故对51具(102侧)成年尸体的內髂、外静脉、骶外侧静脉及闭孔静脉,作了系统观测,并讨论了它们的临床意义。一、髂外静脉长度4.5～15.5cm,平均9.44±0.28cm;上端宽径0.6～2.25cm;平均1.23±0.04cm。髂外静脉内静脉瓣的出现率为40.7±4.86%;其中29.6%只见于右侧,11.1%左右侧均有。均为双叶瓣、瓣的位置距髂总静脉合成点0.4～3.9cm,平均2.2cm。髂外静脉的变异:102例中有2侧左髂外静脉,在左骶髂关节前方,分成内、外两支,内支与左髂内静脉合成左髂总静脉,外支向上右,直接注入下腔静脉。另有一侧左髂外静脉,在左骶髂关节的前方,先分成两支,继又彼此吻合,形成环状髂外静脉。     

髂总静脉隔在下肢静脉曲张中的应用解剖学研究

用68具成人尸体观察测量了髂总静脉间隔,左、右髂总静脉隔.结果:髂总静脉间隔出现率为96.55%(66例),左髂总静脉隔出现率为71.05%(38例),其横径男5.36±0.88(1.00～14.02)mm;女4.18±1.30(0.62～9.32)mm.右髂总静脉隔无1例存在.文内对髂总静脉隔的存在与下肢静脉曲张的形态学关系进行了分析探讨.     

右侧两支髂内静脉分别注入左、右髂总静脉一例

一般教科书中记述,髂内静脉只有一支,平坐骨大孔上缘平面,由盆壁及盆内脏器静脉合成。在解剖一成年女性尸体时,发现其右侧具有2支髂内静脉,并分别入左、右髂总静脉。 右侧髂内静脉分为内、外两支,内支管径0.52cm,长4.4cm,经骶骨前方斜向左上方注入左髂总静脉。外支管径0.5cm,与右髂外静脉汇合成右髂总静脉。左、右髂总静脉管径相     

左髂总静脉缺如一例

有关髂总静脉的变异,文献记载甚少.而报道左侧缺如者迄今未见到.故将教学标本中发现的一例成人女尸静脉变异报道如下:本例的左髂外静脉行于动脉的后内侧,经同侧髂内动脉的后方至髂总动脉的的内侧,斜过第4腰椎体前方抵达第4腰椎体上缘右前方,与右髂总静脉汇合形成下腔静脉.左髂内静脉于左骶髂关节的前外侧接受三支骶外侧静脉.然后,经小骨盆上口斜行至第5腰椎体上缘右侧,汇入右髂总静脉.该静脉在左骶髂关节的上方.左腰大肌的内侧,有一交通支与左髂外静脉相连.右髂总静脉在接纳左髂内静脉前的宽度为14mm,其后为18mm.     

新生儿颈内静脉穿刺置管术的应用解剖

目的为新生儿颈内静脉穿刺置管术提供解剖学基础.方法对15具30侧新生儿尸体标本的颈内静脉及相关结构进行解剖观测.结果颈内静脉外径左(5.6±1.7)mm,右(6.5±1.0)mm.颈内静脉与头臂静脉夹角左(114±8)°,右(145±9)°,颈总动脉与胸锁乳突肌前缘交点位于胸锁乳突肌前缘的近中点处,其交点平面以下颈内静脉长度为(2.7±0.5)cm,左、右头臂静脉和上腔静脉长度分别为2.4、1.4和1.8cm.结论新生儿颈内静脉下段口径粗大,与颈总动脉伴行毗邻清楚,变异较小.穿刺易在颈总动脉与胸锁乳突肌前缘交点稍外侧进针,插管长度左侧为7.0cm,右侧为6.0cm.     

右髂总动脉分支位置异常一例报告

我们在尸体解剖过程中 ,发现一例右髂总动脉分支位置异常的标本。为了积累变异资料和供临床工作者参考 ,现报告如下 :1.本例尸体 :男性 ,体长 16 6 cm,年龄约30岁 ,外观发育正常。2 .腹主动脉走行于脊柱的左前方 ,长2 0 .1cm,管径 1.5 cm,在第五腰椎体上缘分左、右髂总动脉。右髂总动脉自腹主动脉发出后 ,走行于右下方 ,长 2 .2 cm,管径 1.2 cm,在第五腰椎体下缘即分为右髂内、髂外动脉。右髂内动脉管径 0 .5 cm,沿骨盆后壁走行进入骨盆腔后分为数支。右髂外动脉管径 0 .7cm,走行至右下 ,距发出右侧腹壁下动脉处其长度有 11.6 cm。左髂总动…     

旋髂深静脉的解剖学观察及临床应用

目的观察旋髂深静脉的位置、走行及汇成,测量旋髂深静脉的长度、外径,积累人类体质学资料和为临床采用旋髂深静脉与睾丸静脉吻合治疗精索静脉曲张提供形态学基础。方法采用大体解剖法显露、观察、测量20具40侧成年男性旋髂深静脉。结果旋髂深静脉与旋髂深动脉伴行,旋髂深静脉主干出现属支四支旋髂深静脉上支(100%)、旋髂深静脉下支(100%)、旋髂深静脉中支(2.50%)、旋髂深静脉股支(97.50%)。旋髂深静脉主干长37.10±0.28mm,起始处外径2.89±0.13mm,汇入处外径5.19±0.25mm。结论旋髂深静脉主干、旋髂深静脉上支、旋髂深静脉下支可作为睾丸静脉旋髂深静脉吻合治疗精索静脉曲张的选用血管;旋髂深静脉股支在股部与股部的浅静脉、旋股外侧静脉存在吻合,为施行睾丸静脉旋髂深静脉吻合术后睾丸静脉回流提供了通道。     

A case of an additional right external iliac vein surrounding the right external iliac artery and lacking the right common iliac vein

A case of an additional right external iliac vein lacking a right common iliac vein was found in an 84-year-old female cadaver during a dissection course at Aichi Medical University in 2014. The findings are reported and discussed from the embryological and clinical viewpoints. The right and left iliac venous systems were macroscopically observed with attention to the homonymous arteries and the inferior vena cava. In this cadaver, a preaortic external iliac vein originated from a right external iliac vein and drained directly into the inferior vena cava. The preaortic and right external iliac veins surrounded the right external iliac artery. In addition, the right internal iliac vein drained into the left common iliac vein, and the right obturator vein drained into the right external iliac vein. Our findings suggested that normal external iliac veins developed from the ventral limb of the iliac venous system in this case. Our case has clinical importance for surgical complications such as hemorrhages in pelvic operations, phlebography, and especially central venous cauterization of the right femoral vein.     

Isolated bilateral external iliac vein aplasia

We present a case of 11-year-old girl with a history of prominent superficial veins over abdomen and thorax since birth. A superficial vein extending from either inguinal region joined in umbilical region and extended up to right supraclavicular region. Other features of Klippel–Trenaunay syndrome like nevus, limb edema were absent. On radiological investigations both external iliac veins could not be visualized and venous return from lower limbs was draining into the right subclavian vein via these superficial veins. Both external iliac veins could not be identified during surgery.     

Right internal iliac vein joining the left common iliac vein: case report demonstrated by CT angiography

An unusual variation of the iliac veins was detected by computed tomography (CT) angiography in a 35-year-old man. In coronal CT reconstructions, it was shown that the right internal iliac vein of this patient crossed to the left side and drained to the left common iliac vein. This variation is important in retroperitoneal, laparoscopic and orthopedic surgery. We present the CT findings and discuss the embryological origin of this unusual congenital anomaly.

---

Electronic Supplementary Material The french version of this article is available in the form of electronic supplementary material and can be obtained by using the Springer Link server located at .

---

Veine iliaque interne droite tributaire de la veine iliaque commune gauche. Un cas découvert par angio-scanner

Résumé Une variation inhabituelle des veines iliaques a été découverte par tomodensitométrie chez un malade de 35 ans. Les reconstructions coronales ont montré que la veine iliaque interne droite du patient croisait la ligne médiane vers la gauche pour se drainer dans la veine iliaque commune gauche. Cette variation est importante à connaître en chirurgie rétro-péritonéale, laparoscopique et orthopédique. Nous présentons les documents obtenus par tomodensitométrie et discutons l'origine embryologique de cette anomalie congénitale rare.

     

Investigation of adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents in the iliac vein: insights into developing a better iliac vein stent

We analyzed the adverse events associated with an off-label use of arterial stents and CE-marked iliac vein stents for the treatment of iliac venous thromboembolism and investigated their relationships with the anatomical features of the iliac vein, to gain insights into the development of a better iliac vein stent. Reports of adverse events following the use of stents in the iliac vein were retrieved from the Manufacturer and User Facility Device Experience (MAUDE) database that contain suspected device-associated complications reported to the Food and Drug Administration. Data from 2006 to 2016 were investigated. The literature analysis was also conducted using PubMed, Cochrane Library, EMBASE, and Web of Science focusing on English articles published up to 4 October 2016. The analysis of 88 adverse events from the MAUDE database and 182 articles from the literature revealed that a higher number of adverse events had been reported following the use of arterial stents in the iliac vein compared to CE-marked iliac vein stents. While stent migration and shortening were reported only for the arterial stents, stent fracture and compression occurred regardless of the stent type, even though a vein does not pulsate. A study of the anatomical features of the iliac vein implies that bending, compression, and kink loads are applied to the iliac vein stents in vivo. For designing, developing, and pre-clinical testing of stents intended for use in the iliac vein, the above mechanical load environments induced by the anatomical features should be considered.     

Spontaneous rupture of the left external iliac vein

Recently, we have experienced a case of spontaneous rupture of the left iliac vein in a 62-year-old woman, who had been suffering from hemiparesis and chronic constipation. An urgent laparotomy was performed for massive hemoperitoneum without knowing the bleeding point, and laceration on the left external iliac vein was repaired. Spontaneous rupture of the iliac vein is extremely rare. However, it should be included in differential diagnoses of the patient with massive hemoperitoneum who have no known pathology or any evidence of blunt trauma.     

猪髂静脉狭窄模型的建立

目的 探讨髂静脉狭窄动物模型的建立方法。方法 选用实验用白猪12只,采用数字表法随机分为实验组及对照组,每组6只。实验组采用左髂静脉血管外贴附包绕石英管,在左髂静脉于下腔静脉汇入点下方1~2 cm及3~5 cm处结扎髂静脉,然后抽离石英管的方法,建立左髂静脉狭窄动物模型;对照组不行手术。实验组白猪在手术前及术后第30天行血管腔内超声(IVUS)检测左髂静脉汇入下腔静脉处左髂静脉内径,在术后第30天行髂静脉造影检查观察髂静脉通畅情况。在完成检查后处死两组实验动物,取出右髂静脉近心端2.0 cm、左髂静脉起始端至下腔静脉下段“人”字型血管,观察静脉壁病理组织学改变;应用Image-Pro plus图像处理软件测量实验组左髂静脉缩窄处、对照组相应处血管内膜厚度。实验组以左髂静脉直径狭窄率＞30%作为模型制备成功的标准。观察并比较实验组手术前后左髂静脉内径的差异,以及两组动物左髂静脉内膜厚度的差异和组织病理学的改变。结果 实验组动物手术前左髂静脉直径为7.28～8.04(7.53±0.28)mm,术后第30天为3.72～5.02(4.39±0.48)mm,手术前后左髂静脉直径差值为2.32～3.88(3.14±0.57)mm,左髂静脉狭窄率为31.6%～51.1%(41.57%±6.85%),均成功建立了髂静脉狭窄模型;手术前后左髂静脉直径差异有统计学意义(t=13.575,P＜0.05)。术后第30天,实验组动物髂静脉造影显示右髂静脉均通畅,左髂静脉可见明显狭窄;静脉壁组织病理学检查显示:对照组未见异常,实验组血管内膜增生狭窄;实验组左髂静脉内膜厚度为(209.82±26.26)μm,大于对照组的(37.67±6.84)μm,差异有统计学意义(t=15.539,P＜0.05)。结论 在实验白猪体内,采用左髂静脉血管外贴附包绕石英管、在左髂静脉于下腔静脉汇入点下方1~2 cm及3~5 cm处结扎髂静脉后抽离石英管的方法,可成功建立髂静脉狭窄动物模型。该方法具有简便、建模效果稳定的优点。     

右髂总静脉变异1例

在解剖一具中年男性尸体过程中,发现1例右髂内、髂外静脉不汇合成右髂总静脉而直接汇入下腔静脉的异常标本(图1)。现报道如下: