Incidence of retro-aortic left renal vein and its relationship with varicocele

The retro-aortic left renal vein (RLRV) is a malformation characterized by the presence of a vessel that drains the left renal blood up to the inferior vena cava crossing behind the aortic artery. Varicocele is defined as venous dilation of the pampiniform plexus, and the left side is the most commonly affected. Several theories concerning the possible aetiology of varicocele are reviewed in the literature, but RLRV was not mentioned as an aetiologic factor of varicocele. in this study we investigated the percentage of RLRVs and their relation with varicocele. A total of 1,125 contrast-enhanced abdominal CT scans was examined to identify RLRVs. RLRVs were found in nine women (1.6%) and ten men (1.7%). We performed scrotal Doppler ultrasonography (US) for all affected men except one. Varicocele of varying degrees was found in seven of the nine male patients with RLRV (77%). RLRV could be one of the aetiological factors in the development of varicocele, and the cases with RLRV should be examined by scrotal Doppler US for the presence of varicocele.     

Postpartum renal vein thrombosis

Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two post-partum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.     

Postpartum renal vein thrombosis

Renal vein thrombosis in adults is usually a complication of the nephrotic syndrome. Rarely, it has been reported in nonnephrotic women postpartum. The thrombosis may be a complication of the hypercoagulable state associated with both the nephrotic syndrome and pregnancy. Two postpartum patients with renal vein thrombosis and no prior history of renal disease are reported here. Neither patient had heavy proteinuria. In both cases, pyelonephritis was suspected clinically and the diagnosis of renal vein thrombosis was first suggested and confirmed by radiologic examination. Renal vein thrombosis should be considered in women presenting postpartum with flank pain.     

Congenital lipoid nephrosis with left renal vein thrombosis and Chiari's syndrome.

An infant with primary congenital lipoid nephrosis then developed left renal vein thrombosis and secondary hepatic vein obstruction. This was shown by inferior venacavography. The thrombus detached subsequently, and the child died from massive pulmonary embolism.     

Diagnosis of allograft renal vein thrombosis

Allograft renal vein thrombosis has been reported in 1 to 4% of the renal transplants. Salvage of the graft is possible only if there is prompt recognition and operative intervention. We present the case of a living-related renal transplant that was salvaged because of early diagnosis of allograft renal vein thrombosis by correlation of the radioisotopic angiogram, renogram and duplex doppler sonography.     

Retroaortic left renal vein joining the left common iliac vein

Retroaortic left renal vein joining the left common iliac vein is a rare congenital anomaly in the development of the inferior vena cava. To our knowledge, only one case has been reported in the literature; however, its imaging features have never been described. A 27-year-old male presented with a 1-year history of recurrent right flank pain, dysuria, hematuria, and fever (39 °C). Computed tomography and MR venography showed a retroaortic left renal vein joining the left common iliac vein. We present the CT and MR venography findings and discuss their feasibility in showing this congenital anomaly. Received: 18 October 1999; Revised: 11 February 2000; Accepted: 15 February 2000     

Retroaortic left renal vein with renal vein hypertension causing hematuria

We describe a case of retroaortic left renal vein with hematuria. In this case, pullback pressure from the retroaortic left renal vein to the inferior vena cava revealed left renal vein hypertension according to criteria of the “nutcracker phenomenon.” We stress that left renal vein anomaly including retroaortic left renal vein can cause clinical symptoms such as hematuria.     

The specificity of renal vein thrombosis.

Clinical and roentgenographic features of renal vein thrombosis are discussed. The authors' experience with 17 cases is presented. The roentgenologist with a high degree of suspicion can, by correlation of clinical and urographic findings, make the specific diagnosis of renal vein thrombosis in a high percentage of cases.     

CT diagnosis of renal vein thrombosis in nephrotic syndrome

Forty-seven patients with nephrotic syndrome were prospectively studied for renal vein (RVT) and inferior vena caval (IVCT) thrombosis with dynamic CT. Renal venography and inferior vena cavography was performed on the 12 patients with and on 5 of the patients without CT evidence of thrombosis. Dynamic CT revealed thrombi in 12 of 47 (26%) of the cases (RVT in 8, IVCT in 5); all were confirmed by venography. In one of the cases with RVT, a thrombus in a superior branch of the left renal vein was revealed by venography but not by CT. Venography was normal in all five patients evaluated with normal dynamic CT. We believe that dynamic CT can be used to effectively examine patients with suspected RVT.     

Compression of the left common iliac vein in asymptomatic subjects and patients with left iliofemoral deep vein thrombosis

PURPOSE: To retrospectively evaluate compression of the left common iliac vein as demonstrated at computed tomography (CT) in patients with iliofemoral deep vein thrombosis due to iliac vein compression syndrome (IVCS) and compare compression ratios with those of asymptomatic subjects. MATERIALS AND METHODS: Between March 2003 and June 2007, compression of the left common iliac vein by the right common iliac artery, as demonstrated with CT, in 34 patients (25 women and nine men; mean age, 51 years; age range, 21-79 years) with IVCS was retrospectively evaluated. Compression ratios were compared with those of 34 age- and sex-matched asymptomatic subjects. A t test was used to compare the compression ratios. RESULTS: The percentages of compression of the left common iliac vein were 45%-100% (mean, 74% +/- 17) for patients with IVCS and 0%-68% (mean, 28% +/- 20) for control subjects (P < .05). Of the 34 patients with IVCS, 11 (32%) had less than 70% compression and 23 (68%) had at least 70% compression. CONCLUSIONS: There was considerable overlap between the degree of compression in patients with IVCS and control subjects. Compression of the left common iliac vein was significantly more prominent in patients with lower extremity deep vein thrombosis due to IVCS when compared with control subjects. Compression in excess of 70% as demonstrated at CT can be helpful for identifying possible underlying IVCS in patients with a left lower extremity deep vein thrombosis.