ASPLENIA AND POLYSPLENIA SYNDROME

This report described the morphological characteristics of seven cases of asplenia syndrome and three of polysplenia syndrome. Each syndrome has been characterized by a tendency for symmetric development of normally asymmetric organs, with varying degrees of cardiovascular anomalies. These latter anomalies are usually present in asplenia syndrome to a greater extent than in polysplenia syndrome. While, as observed in our material, the conotruncal anomalies were present more commonly in cases with asplenia, and absence of inferior vena cava with azygos continuation was seen specifically in all the cases with polysplenia. This evidence implied the presence of some pathogenetic distinction between the two syndromes. ACTA PATHOL. JPN. 32: 505∼511, 1982.     

Preduodenal portal vein,intestinal malrotation,polysplenia, and interruption of the inferior vena cava: a review of anatomical anomalies associated with gastric cancer

Purpose  

Anatomical anomalies of visceral organs associated with gastric cancer are extremely rare. Here, we report a case of preduodenal portal vein (PDPV), intestinal malrotation, interruption of the inferior vena cava (IVC), and polysplenia associated with gastric cancer in an adult patient, together with a review of the literature on the anomalies of visceral organs associated with gastric cancer.     

Inferior vena cava duplication with reference to venous asymmetries

Congenital anomalies of the inferior vena cava are relatively frequent, usually with scarce clinical impact. There are few cases reported of inferior vena cava duplication. The supernumerary left-placed vena cava originates in the pelvis from a common iliac vein and receives ipsilateral lumbar and renal veins. Here we examine a new case of inferior vena cava duplication, diagnosed by CT scan. This case is then discussed in view of the physiological asymmetries of the venous system. Embryological implications are discussed and compared to recent findings of genes that control the asymmetry of visceral organs.     

Interruption of the inferior vena cava with azygos termination associated with congenital absence of portal vein

The authors report an exceptional and well-documented case of interruption of the retrohepatic segment of the inferior vena cava with an “azygos continuation”, combined with absence of the portal vein. The only known combination of congenital anomalies of the inferior vena cava and the portal vein was that of an “azygos continuation” and a preduodenal portal vein. The double interruption, portal and inferior caval, may be associated with a disturbance of preferential flows induced by the left umbilical thrust. According to hemodynamic theory, the left umbilical flow is the determining factor in organogenesis of the portal vein and the retrohepatic segment of the inferior vena cava.     

下腔静脉滤器置入预防肺栓塞

背景：下腔静脉滤器置入预防肺栓塞是有效的,也为手术取栓提供了安全保障。 目的：探讨下腔静脉滤器临床应用的研究进展。 方法：由第一作者检索1985/2010 FMJS数据库及万方数据库有关下腔静脉滤器材料学的发展,置入的适应证、禁忌证,置入技术,并发症及置入后抗凝问题方面的文献。 结果与结论：下腔静脉滤器材料学发展迅速,其置入技术显著提高,但对其临床应用指针还没有统一的认识。对于置入后抗凝问题认识也存在差异,而滤网位置偏移、游走、成角及腔静脉穿孔和对周围脏器的损伤报道随着下腔静脉滤器应用的增多而相应增多。下腔静脉滤器置入预防肺栓塞的临床疗效是值得肯定的,但应该高度重视置入后的并发症及其严重性,相信随着下腔静脉滤器材料学的进一步发展及生物相容性的提高,其临床应用前景会越来越广阔。关键词：下腔静脉滤器;深静脉血栓;肺栓塞;置入;综述文献 doi:10.3969/j.issn.1673-8225.2012.16.033     

Anomalous inferior vena cava with azygos continuation in a japanese man

During an ordinary dissection by medical students at Nara Medical University in 1998, a case of anomalous inferior vena cava with azygos continuation was found in a cadaver of a 91-year-old Japanese man. The left and right inferior venae cavae were present and were joined at the height of the first lumbar vertebra. The joined inferior vena cava continued the azygos vein and the azygos vein entered the superior vena cava at the height of the fifth thoracic vertebra. Furthermore, the heart was normal.     

肠系膜上静脉外科干及下腔静脉下段的应用解剖观察

本文解剖了30具成人尸体,对肠系膜上静脉外科干、下腔静脉下段的位置、长度、外径、两者的相互关系以及前者与肠系膜上动脉分支后者与腹主动脉分支的关系等进行了观察测量。认为国人的外科干至少80％能满足手术中行肠腔静脉吻合术应具备的四点要求。     

Anomalous veins of the retroperitoneum: clinical considerations

A case of complex anomalies (variations) of the veins of the retroperitoneum in a 57 year old male cadaver is presented. The anomaly involved a double inferior vena cava, with the left suprarenal v. draining into the left vena cava and the right testicular v. drained into the right renal v.. There was also no left common iliac v., with the left external iliac v. draining into the left vena cava and the left internal iliac v. into the right common iliac v.. Although duplication of the inferior vena cava has previously been reported the present case is interesting because of the complexity of the associated anomalies.     

Anomalous veins of the retroperitoneum: clinical considerations

Abstract: A case of complex anomalies (variations) of the veins of the retroperitoneum in a 57 year old male cadaver is presented. The anomaly involved a double inferior vena cava, with the left suprarenal v. draining into the left vena cava and the right testicular v. drained into the right renal v., There was also no left common iliac v., with the left external iliac v. draining into the left vena cava and the left internal iliac v. into the right common iliac v.. Although duplication of the inferior vena cava has previously been reported the present case is interesting because of the complexity of the associated anomalies.     

A rare case of a complete left inferior vena cava associated with the symptoms of Dunbar syndrome

We report a case of an 82-year-old female with an anomalous left inferior vena cava. The left inferior vena cava ascends parallel and to the left of the descending abdominal aorta. At the level of the celiac trunk, the inferior vena cava courses anteriorly and to the right to reach the posterior surface of the liver. The patient also suffers from chronic mild postprandial abdominal pain. It is possible that position of inferior vena cava anterior to the aorta, at the level of the celiac trunk, may lead to intermittent celiac artery compression syndrome (Dunbar syndrome).     

Ieiomyosarcoma of the superior vena cava producing superior vena cava syndrome and heart tamponade

An autopsy case of primary leiomyosarcoma arising in the superior vena cava is presented. A 44 year old Japanese man presented with superior vena cava syndrome and eventually died due to heart tamponade and acute renal failure. Autopsy revealed that the superior vena cava was occluded with a tumor that had invaded the pericardium and right thoracic cavity. Primary caval venous leiomyosarcoma is a rare but lethal disease and most cases arise from the inferior vena cava. This case represents a very rare case of leiomyosarcoma with the rare clinical findings of superior vena cava syndrome and heart tamponade.     

Noninvasive photoacoustic imaging of the thoracic cavity and the kidney in small and large animals

The internal organs of rats and rabbits were clearly imaged noninvasively using a deeply penetrating reflection-mode photoacoustic imaging system. This imaging system had previously been found to provide an imaging depth limit of approximately 38 mm. In the thoracic cavity, major blood vessels connecting to the heart were imaged, and the right atrium was imaged as deeply as approximately 8 mm. In the abdominal cavities, the kidney and vena cava inferior were also imaged in situ. The vena cava inferior approximately 13.7 mm deep was imaged. The kidney of a New Zealand white rabbit was also imaged. This study shows the deep internal organ imaging capability of the system in animals. This technology can potentially be used to study tumors in internal organs, and be adapted to clinical diagnosis.     

Leiomyosarcoma of the inferior vena cava

A 61-year-old woman with symptoms of inferior vena caval obstruction was investigated with computed tomography and ultrasound imaging and found to have a tumor of the inferior vena cava. Transvenous biopsy revealed a leiomyosarcoma, which at surgical exploration was considered to be unresectable. Autopsy showed that the tumor extended form its origin in the inferior vena cava just above the left renal vein to the right atrium. Hepatic metastases were documented. This rare tumor has seldom been diagnosed prior to exploratory surgery or necropsy and should be included in the differential diagnosis of inferior vena caval obstruction. The case illustrates the relative ease and efficacy of transvenous biopsy in establishing this diagnosis antemortem.     

The pathogenesis of hyaline globules in liver cells after partial hepatectomy in rats

To clarify the pathogenesis of hyaline globules in liver cells after partial hepatectomy, the present study was undertaken in rats. When partial hepatectomy was performed by the surgical procedure of Higgins and Anderson, the inferior vena cava pressure was raised, and many hyaline globules, which are very similar to those caused by condensation of the contents of vacuoles in liver cells after temporary pressure elevation of the inferior vena cava, were induced in liver cells. On the other hand, when the median lobe and the left lateral lobe were removed carefully one at a time to avoid operative narrowing of the inferior vena cava, the inferior vena cava pressure was not elevated, and only very few hyaline globules were formed. This suggests that hyaline globules in liver cells following partial hepatectomy in rats may be caused by elevation of inferior vena cava pressure due to narrowing of the inferior vena cava by surgical procedure.     

下腔静脉滤器回收后血管形态改变的CT静脉造影研究

目的 探讨下腔静脉滤器回收后肾下段下腔静脉CT静脉造影(CTV)血管壁形态的改变,并分析相关影响因素。方法 回顾性研究。纳入2015年1月-2018年2月在北京积水潭医院血管外科下腔静脉滤器回收后规范抗凝治疗70例患者的下腔静脉CTV图像为滤器组,男34例、女36例,年龄17~79(48.11±13.86)岁;在北京积水潭医院下腔静脉CTV数据库中随机抽取40例非血栓性疾病患者为对照组,男23例、女17例,年龄18~70(46.70±12.16)岁。在下腔静脉CTV图像上测量并比较两组下腔静脉最小直径和肾静脉开口下方1 cm平面参考直径的差异;观察滤器组肾下段下腔静脉壁有无增厚,应用logistic回归分析其影响因素。结果 两组患者的性别、年龄差异均无统计学意义(P值均＞0.05)。滤器组和对照组下腔静脉参考直径分别为(16.0±2.6)、(20.2±2.4) mm,最小直径分别为(13.0±3.6)、(19.3±2.3)mm,差异均有统计学意义(t=8.267、10.032,P值均＜0.01)。滤器组35.7%(25/70)的患者血管壁局限性或环状增厚,下腔静脉最小直径为(10.3±3.6)mm; 64.3%(45/70)患者没有血管壁增厚,下腔静脉最小直径为(14.5±2.5)mm,差异有统计学意义(t=5.330, P＜0.01)。血管壁增厚患者与无增厚患者的下腔静脉血栓形成、下腔静脉参考直径差异均有统计学意义(χ²=6.459, t=3.794, P值均＜0.05);logistic多因素分析显示,下腔静脉血栓形成和下腔静脉参考直径是下腔静脉壁增厚的独立影响因素(OR=5.410、1.500,P值均＜0.01)。结论 滤器回收后下腔静脉会出现不同程度的狭窄和血管壁增厚,下腔静脉血栓形成和较小的下腔静脉参考直径明显增加下腔静脉壁增厚的风险。     

Situs inversus with levocardia,infrahepatic interruption of the inferior vena cava,and azygos continuation: a case report

Situs inversus incompletus is a rare congenital condition in which the major abdominal organs are reversed or mirrored from their normal positions. It is often associated with multiple congenital anomalies. We present the case of a 38-year-old woman with dyspnea and a clinical history of chronic kidney disease and kidney transplantation. Echocardiography showed a right atrial mass, and analysis of multidetector computed tomography angiography revealed the interruption of the inferior vena cava with an increase of the azygos vein and azygos continuation. These congenital malformations are often associated with deep vein thrombosis and/or pulmonary thromboembolism and explained the occurrence of dyspnea. Cardiac magnetic resonance with contrast medium confirmed the presence of the right atrial mass, the characteristics of which were attributed to interatrial thrombus, which was further confirmed by the success of thrombolytic therapy and the remission of symptoms. In conclusion, we described a case of situs inversus with levocardia in association with infrahepatic interruption of the inferior vena cava, and azygos continuation with cardiac thrombus and chronic renal failure.     

Innervation pattern of inferior vena cava in mouse and rat

Summary The innervation pattern of rat and mouse inferior vena cava was studied using catecholamine fluorescence and cholinesterase histochemical methods.Adrenergic nerve fibers innervate only abdominal protions of the inferior vena cava, while cholinergic nerves are chiefly distributed to the thoracic inferior vena cava and show a gradual decrease in the abdomen.Chemical sympathectomy performed with the neurotoxin 6-hydroxydopamine does not alter the pattern of cholinergic innervation of the inferior vena cava, suggesting the parasympathetic nature of cholinergic nerves.     

心腔内导管超声在腹膜后脏器显像中应用研究

目的通过动物实验评价心腔内导管超声探头对部分腹膜后脏器结构的显像效果，以及其用于腹膜后脏器显像的可行性。方法静脉鞘管引导心腔内导管超声探头进入下腔静脉，通过对8只实验犬部分腹膜后脏器的近距离超声成像，记录成像过程动物生理参数，观察其二维图像及彩色血流显像效果，并与常规经腹超声检查效果比较。结果实验前与腔内显像过程中犬的心率、动脉压、呼吸频率差异无统计学意义（P〉0．05）；心腔内导管超声可清晰显示肾脏、肾上腺、大血管旁淋巴结等腹膜后脏器的二维细微结构及彩色血流分布，成像质量明显优于经腹切面的显示效果。结论采用心腔内导管超声观察腹膜后部分脏器的结构是安全可行的，成像质量明显优于经腹切面的显示效果，对肾上腺及其血供的显像尤为清晰。心腔内导管超声在腹膜后脏器显像方面有重要应用价值，为腹膜后脏器的超声检查提供了一种新方法。     

Left inferior vena cava with regressed right inferior vena cava

A left inferior vena cava was found in the cadaver of an 88-year-old Japanese man during a student dissection course at Kumamoto University School of Medicine. The right common iliac vein ascended obliquely toward the left behind the right common iliac artery and united with the left common iliac vein to form the inferior vena cava in front of the fifth lumbar vertebral body behind the left common iliac artery. The inferior vena cava ascended on the left side to the aorta, and after the left renal vein joined to it at the level of the third lumbar vertebral body, it turned obliquely to the right and crossed superficially to the aorta. At the right side of the aorta, the common stem of the third lumbar vein and the posterior renal vein was joined to the oblique part. The inferior vena cava then ascended, receiving the right renal vein as it would normally. The inferior vena cava is thought to develop symmetrically but this left inferior vena cava shows a persistence of the left channel of the infrarenal part, which normally disappears. Although the common stem of the veins that joined to the oblique part on the right side did not continue to the right common iliac vein, gross anatomical findings suggested it to be the remnant of the right inferior vena cava.     

A review of venous collaterals in inferior vena cava obstruction

The purpose of this study was to review venous collateralization resulting from inferior vena cava obstruction. The elements responsible for the extent and distribution of venous collaterals in inferior vena cava obstruction and whether or not the obstructive lesion involves tributaries of the inferior vena cava. Common etiologies of inferior vena cava obstruction include extensions of iliofemoral vein thrombi, thrombosis from intraluminal tumors or following trauma, and external compression. The anatomy of the venous collateral systems may be divided into deep and superficial networks, each of which is composed of systems of primary or secondary clinical significance, as defined by the degree of restoration of adequate venous return and the extent of visceral venous decompression. The most common obstructions of the inferior vena cava involve the lower third of the vessel. The azygos-hemiazygos and vertebral venous plexus systems play the most significant roles, while the superficial systems are less prominently involved. In upper level inferior vena cava obstruction, reestablishment of venous circulation is less developed, which usually leads to a poorer clinical outcome. © 1992 Wiley-Liss, Inc.