Obstruction Of Inferior Vena Cava Research Articles

The normal and abnormal left superior intercostal vein.

A study of 500 normal erect posteroanterior chest radiographs was undertaken to determine the incidence of visualization and size of the left superior intercostal vein in normal individuals. The vein produces a small "nipple" lateral to the aortic knob on 1.4% of normal erect posteroanterior chest films; its diameter can be up to 4.5 mm in normal patients. Dilatation of the vein beyond 4.5 mm is a useful sign of a circulatory abnormality warranting further study. Dilatation may be due to absence of the inferior vena cava, hypoplasia of the left innominate vein, congestive failure, portal hypertension, Budd-Chiari syndrome, or superior or inferior vena caval obstruction. The differential diagnosis of an enlarged left superior intercostal vein includes mediastinal mass, especially lymphadenopathy, and aneurysm of the arch of the aorta.

Surgery of tumors of the subdiaphragmatic inferior vena cava

Two cases of obstruction of the hepatic inferior vena cava (IVC) are presented. In Case 1, the obstruction was due to a calcified thrombus which presumably developed after lower limb trauma 19 months previously. Complete surgical correction was achieved with the aid of deep hypothermia and circulatory arrest. In Case 2, a right atrial tumor was mimicked by a propagating malignant hepatoma. Palliative removal of the tumor cleared the IVC passage. The etiology of tumors of the IVC and their surgical management are discussed.

A case of the unusual collateral circulation in inferior vena cava obstruction

A case of the unusual collateral circulation in inferior vena cava obstruction

Single-passage extraction and permeability estimation of sodium in normal dogs lungs.

Bolus injections of 24NaCl, 131I-albumin, and indocyanine green dye were made into the right atria of anesthetized, ventilated dogs. Blood was sampled from the femoral artery, and from the dilution curves, instantaneous extractions, E2(t), and area averaged extractions, E3(t), were calculated for sodium at various plasma flows (Fp). Flow reduction was produced by transient inferior vena cava obstruction. E2(t) and E3(t) within any dilution curve generally started off with a high value, then decreased with time. The E3 that occurred at the peak of the albumin-dilution curve were about 0.11 for plasma flow of 0.75 liter/min and tended to decrease as flow increased. Parallel study of the sodium extravascular space at equilibrium gave values of 0.3-0.4 g of plasma sodium per g of tissue, suggesting that this volume is not infinitely small. Since the E was low it is unlikely that the high initial E(t) and the decreasing E(t) were due to early back flux. Calculation of capillary permeability surface area product [PS = Fp loge (1 - E)] showed an increasing PS with plasma flows. The injection of 9-mum microspheres at low and high total blood flow gave evidence supporting a decrease of capillary surface area (S) with decreasing total blood flow. Regional pulmonary blood flow also showed marked heterogeneity. Because of the low average extraction of sodium in the lung, insensitivity of the method in normal lungs cannot be excluded.

Inferior Vena Cava Obstruction Secondary to Indwelling Venous Catheters: Two Cases

It has been common practice to leave an indwelling venous catheter with its tip in the inferior vena cava (IVC) following cardiac catheterization in ill infants who are to subsequently undergo corrective or palliative surgery. A polyvinyl chloride catheter may be conveniently inserted into the same vein employed for the diagnostic catheterization in order to monitor central venous pressures and deliver intravenous fluids. Two instances of thrombosis of the IVC which occurred following the use of indwelling femoral venous catheters, placed after cardiac catheterization, are reported. Not only is this complication particularly serious from the standpoint of potential thromboembolism, but it also eliminates the use of the IVC approach in a group of patients who require repeated cardiac catheterizations.

Transient protein-losing enteropathy secondary to elevated caval pressures and caval obstruction after the Mustard procedure

Protein-losing enteropathy, documented by 51Cr-labeled albumin excretion studies, was demonstrated in a 24-month-old girl following the Mustard operation for complete transposition. Apparent postoperative inferior vena cava obstruction had been diagnosed by angiocardiograms and both caval pressure were found to be elevated. There was no evidence of primary renal or hepatic disease or cardiac failure. This problem may occur more frequently than has been recognized.

Inferior Vena Cava Obstruction in Whipple Disease

WHIPPLE disease is an uncommon but treatable disorder that affects the small intestine and virtually any organ system of the body. Malabsorption, fever, arthritis, and generalized lymphadenopathy are frequently characteristic features. The purpose of this communication is to report an unusual presentation of the disease: massive retroperitoneal lymphadenopathy causing inferior vena cava obstruction. Further, the unusual histologic features of noncaseating granulomas within these lymph nodes suggested a sarcoid-like process until the results of a small intestinal biopsy confirmed the diagnosis of Whipple disease. <h3>Report of a Case</h3> A 60-year-old man entered Providence Hospital with urologic symptoms of frequency, nocturia, and dysuria. After routine examination, a transurethral resection of benign prostatic hypertrophic tissue was performed without event. During recovery, the patient told us of increasing edema of both legs and of foamy, foulsmelling stools occurring frequently over the past six months that had unexpectedly improved during short courses of antibiotic therapy

Inferior vena cava obstruction in Whipple disease. Association with retroperitoneal lymphadenopathy

Inferior vena cava obstruction in Whipple disease. Association with retroperitoneal lymphadenopathy

Primary Inferior Vena Cava Thrombosis

All cases of inferior vena cava obstruction diagnosed at the Mayo Clinic between 1950 and 1973 were reviewed. Diagnosis was confirmed by surgery, phlebography, or postmortem examinations in 64 cases; the cause in 55 cases is described. Carcinoma of the kidney was the most common cause (31% pf cases). In nine cases, extensive laboratory investigation failed to reveal the cause of the process. These cases were considered to be primary inferior vena cava thrombosis and are reviewed in detail.

New observations in the clinical spectrum of the Budd-Chiari Syndrome.

Some observations on the natural history, surgical management and metabolic phenomena in B.C.S. are presented. In one patient side to side portocaval shunt brought dramatic improvement with asymptomatic followup of 5 years. The patient died of causes unrelated to B.C.S. At postmortem the shunt was patent and normal liver architecture was preserved. The second patient presented with a fulminant course culminating in acute hepatorenal syndrome. There was marked hypofibrinogenemia and extreme elevation of SGOT. Emergency portocaval shunt was followed by marked improvement in liver status. The patient died of respiratory complications on the 8th postoperative day. The third patient is one year on conservative treatment only and well. In this patient excessive renal tubular reabsorption of sodium at a distal site was documented. This may explain the generalised edema formation in patients with B.C.S. even without inferior vena cava obstruction. This is apparently the first reported instance of renal tubular function studied in B.C.S.

Urographic and barium enema appearance in inferior vena caval obstruction. Case report.

The authors present a case of complete obstruction of the inferior vena cava secondary to metastatic testicular tumor with interesting urographic and barium enema findings. These included a pear-shaped bladder, marked elevation of the sigmoid colon, and extrinsic narrowing of the rectum.

Partially obstructed hepatic portion of inferior vena cava diagnosed by percutaneous hepatography.

Partially obstructed hepatic portion of inferior vena cava diagnosed by percutaneous hepatography.

The effect of potassium and extracellular volume on renal bicarbonate reabsorption

Bicarbonate reabsorption was measured in dogs infused with either KCl or KHCO 3. As has been previously reported, potassium loading depressed bicarbonate reabsorption. Similar studies in dogs with partial obstruction of the thoracic inferior vena cava failed to demonstrate an effect of potassium loading on bicarbonate reabsorption. Extracellular volume was expanded with isotonic saline in three groups of dogs: one with potassium depletion, a second with hyperkalemia, and a third normal group. Bicarbonate reabsorption varied inversely with fractional chloride excretion in all three groups. At any one level of fractional chloride excretion, however, bicarbonate reabsorption was higher in the potassium depleted animals than in the normal dogs, and higher in the normal dogs than in those subjected to potassium loading. This study demonstrates a significant regulatory role of potassium over renal bicarbonate reabsorption. This role can only clearly be defined, however, when the precise state of effective extracellular volume is delineated.

Nonsurgical Inferior Vena Cava Obstruction for Prevention of Pulmonary Emboli

Four acutely ill patients with multiple, recurrent pulmonary emboli, despite adequate anticoagulation therapy, have had the Mobin-Uddin inferior vena cava filter implanted at the time of diagnostic cardiac catheterization. In each patient, clinical improvement has occurred without significant morbidity, and there has been no instance of repeated major pulmonary embolization. This new device can be inserted quickly and safely in acutely ill patients without need for extensive surgery or general anesthesia. This report documents the clinical course of the patients, and the potential advantages of the method.

Nonsurgical inferior vena cava obstruction for prevention of pulmonary emboli

Four acutely ill patients with multiple, recurrent pulmonary emboli, despite adequate anticoagulation therapy, have had the Mobin-Uddin inferior vena cava filter implanted at the time of diagnostic cardiac catheterization. In each patient, clinical improvement has occurred without significant morbidity, and there has been no instance of repeated major pulmonary embolization. This new device can be inserted quickly and safely in acutely ill patients without need for extensive surgery or general anesthesia. This report documents the clinical course of the patients, and the potential advantages of the method.

Effect of renal denervation on the antinatriuresis of caval constriction.

ARTICLESEffect of renal denervation on the antinatriuresis of caval constrictionM Azer, R Gannon, and GJ KaloyanidesM Azer, R Gannon, and GJ KaloyanidesPublished Online:01 Mar 1972https://doi.org/10.1152/ajplegacy.1972.222.3.611MoreSectionsPDF (1 MB)Download PDF ToolsExport citationAdd to favoritesGet permissionsTrack citations ShareShare onFacebookTwitterLinkedInWeChat Previous Back to Top Next Download PDF FiguresReferencesRelatedInformationCited ByNorepinephrine stimulates the epithelial Na+ channel in cortical collecting duct cells via α2-adrenoceptorsMorag K. Mansley, Winfried Neuhuber, Christoph Korbmacher, and Marko Bertog1 March 2015 | American Journal of Physiology-Renal Physiology, Vol. 308, No. 5Expression of multiple α-adrenoceptor isoforms in rat CCDTeresa W. Wilborn, Duo Sun, James A. Schafer, and (With the Technical Assistance of Li Li and Mary Lou Watkins)1 July 1998 | American Journal of Physiology-Renal Physiology, Vol. 275, No. 1Clonidine inhibits fluid absorption in the rabbit proximal convoluted renal tubuleKidney International, Vol. 38, No. 1Comparison of resting and stimulus-evoked catecholamine release from the femoral and renal vascular beds of the dogJournal of the Autonomic Nervous System, Vol. 25, No. 2-3Renal overflow of noradrenaline and dopamine to plasma during hindquarter compression and thoracic inferior vena cava obstruction in the dogActa Physiologica Scandinavica, Vol. 127, No. 3The role of the adrenergic nervous system in sodium and water excretionKlinische Wochenschrift, Vol. 61, No. 21Regulation of sodium and water excretion by catecholaminesLife Sciences, Vol. 32, No. 9Disturbed volume homeostasis in patients with cirrhosis of the liverKidney International, Vol. 23, No. 2Kidney and Liver Function in Rats during the Edema following Constriction of Thoracic Inferior Vena Cava with and without Adrenalectomy or Hypophysectomy24 April 2009 | Acta Medica Scandinavica, Vol. 212, No. S668The functions of the renal nerves21 June 2005Angiotensin receptors in glomeruli differ from those in renal arteriolesKidney International, Vol. 19, No. 5Effects of renal and hepatic venous congestion on renal function in the presence of low and normal cardiac output in dogs.Circulation Research, Vol. 47, No. 6Role of cardiac vagal c-fibers in cardiovascular control21 June 2005Serial evaluation of the renin-angiotensin-aldosterone system in caval dogs.Circulation Research, Vol. 42, No. 6Effect of angiotensin II inhibition in the bile-duct-ligated dogJournal of Surgical Research, Vol. 24, No. 4Impaired proximal tubular transport functions in anaesthetized splanchnicotomized dogsExperientia, Vol. 33, No. 1Natriuretic hormone--its possible role in fluid and electrolyte disturbances in chronic liver diseasePostgraduate Medical Journal, Vol. 51, No. 598 More from this issue > Volume 222Issue 3March 1972Pages 611-616 Copyright & PermissionsCopyright © 1972 by American Physiological Societyhttps://doi.org/10.1152/ajplegacy.1972.222.3.611PubMed5022671History Published online 1 March 1972 Published in print 1 March 1972 Metrics

Relationship of sodium reabsorption and glomerular filtration rate to renal glucose reabsorption.

Glucose reabsorption was measured in dogs in which sodium reabsorption was stimulated by obstruction of the thoracic inferior vena cava or inhibited by volume expansion with Ringer's lactate. Glucose reabsorption was much higher during periods of enhanced sodium reabsorption than during sodium diuresis. The relationship of glucose reabsorption to glomerular filtration rate was examined using data from animals that had fractional sodium excretion rates of less than 1%. Under this condition the relationship of glucose reabsorption to glomerular filtration rate is highly linear. When points obtained during sodium diuresis (C(Na)/GFR>0.1) are plotted on the same graph, glucose reabsorption at any given glomerular filtration rate is much less than during antidiuresis. Glucose reabsorption divided by glomerular filtration rate varies inversely with fractional sodium excretion. This study demonstrates that glomerular tubular balance for glucose exists in the dog and that this balance is changed when sodium reabsorption changes.

Hidden Hypernephroma Simulating Right Atrial Tumor

A case is presented of tumor obstruction of the inferior vena cava with extension into the right atrium. This is the first recorded instance of such tumor extension into the heart which was recognized and treated during the patient's lifetime. The importance of renal malignancy, even without urological signs and symptoms, is stressed as a cause of inferior vena cava obstruction with extension into the atrium. In circumstances such as those reported in this case, a right atrial mass discovered on angiography is more likely to be a secondary extension of a tumor-thrombosed inferior vena cava than a primary cardiac neoplasm.

Multifocal fibrosclerosis with subcutaneous involvement.

A 30-year-old woman developed progressive inferior and superior vena caval obstruction over a 5-month period. This was followed by evidence of hepatic dysfunction and, shortly before her death, by renal failure. The autopsy findings included mediastinal and retroperitoneal fibrosis with obstruction of both vena cavae and the renal, portal, and hepatic veins. The intrahepatic bile ducts were surrounded by scar tissue. The unique feature of this case was fibrosis of the abdominal subcutaneous adipose tissue, a finding previously unreported. The fibrosclerotic diseases are morphologic inflammations which clinically occasionally behave in an aggressive fashion simulating malignant neoplasms. In spite of considerable speculation concerning their pathogenesis, they remain idiopathic.

Membranous obstruction of the hepatic portion of the inferior vena cava. Surgical correction and etiological study.

Two cases are reported of segmental occlusion of the hepatic inferior vena cava (IVC). One showed radiological evidence that the segmental lesion developed from a membranous occlusion during the course of hospitalization. In both cases, the caval obstruction was corrected by finger fracture. Patient 2 was cured, whereas patient 1, subjected to a heart-lung bypass, died in postoperative shock. An analysis is made of 74 operations performed in Japan for occlusion of the hepatic segment of the IVC. More favorable results were attained by the finger-fracture technique than by other procedures. On the basis of a review of 205 reported cases with obstruction of the hepatic IVC or hepatic veins, or both, these obstructive lesions were classified into seven types. Membranous lesions lying above the right hepatic vein orifice are particularly numerous. The etiological findings of the membranous lesions are discussed, and an attempt is made to explain the development of different types of membranous obstructions from the point of view of developmental anomalies.