Abstract
Double inferior vena cava (d-IVC) is a subtype of vascular anomaly that rarely needs treatment. Here, we present a rare case of d-IVC accompanied with concurrent renal pelvis and bladder carcinoma. Due to misdiagnosis, the anomalous left inferior vena cava (IVC) entering the left renal vein was mistaken as the gonadal vein and was then severed during the radical nephroureterectomy. Fortunately, the injured left IVC was recognized correctly during the following cystectomy. The vascular reconstruction operation was performed to recanalize the left iliac veins by anastomosing the ligated vascular stump to the right IVC in an ‘end-to-side’ way. During the hospitalization, the patient was treated with ‘low molecular weight heparin’ and then warfarin to ensure an ideal international normalized ratio. He recovered well from the surgery. A meticulous and comprehensive analysis of radiographic imaging is critical to avoid misdiagnosis of d-IVC.
Highlights
The inferior vena cava (IVC) stems from three pairs of embryonic veins, whose embryogenesis involves development, regression, anastomosis, and replacement of them [1]
D-IVC has been reported to accompany with at least four types of pelvic venous variation, the duplicated left IVC generally drains into the left renal vein and enters normally into the right IVC without other incidental anatomic variations just like our case [4]
As the preoperative computed tomography (CT) images displayed, the mis-ligated branch of the left renal vein went down to become the ipsilateral iliac vein without visible collateral vasculature with the contralateral veins, which indicated a case of d-IVC anomaly (Figure 1C,D,E)
Summary
The inferior vena cava (IVC) stems from three pairs of embryonic veins (posterior cardinal, subcardinal, and supracardinal veins), whose embryogenesis involves development, regression, anastomosis, and replacement of them [1]. D-IVC has been reported to accompany with at least four types of pelvic venous variation, the duplicated left IVC generally drains into the left renal vein and enters normally into the right IVC without other incidental anatomic variations just like our case [4]. * Correspondence: zhangwei@zjcc.org.cn 2Department of Urology, Zhejiang Cancer Hospital, 38 Guangji Road, Hangzhou 31002 Zhejiang, People’s Republic of China Full list of author information is available at the end of the article
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