DOCSLIB.ORG

CT Findings of Bilateral Inferior Vena Cava: Differentiation from Dilated Retroperitoneal Veins

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
CT Findings of Bilateral Inferior Vena Cava: Differentiation from Dilated Retroperitoneal Veins 대 한 방 사 선 의 학 회 지 1993; 29 (6) : 1187~1193 Journal of Korean Radiological Society, November, 1993 CT Findings of Bilateral Inferior Vena Cava: Differentiation from Dilated Retroperitoneal Veins Kyung Joo Park, M.D., Si Kyung Lee, M.D., Joo Hyuk Lee, M.D. Depaγtη~ eη t 01 Radiology, Kα， η!gn am Geη e ra l Hosp i t，αl - Abstract - We expierienced five cases of bilateral inferior vena cava for recent one year. We evaluated the CT findings of the cases and of dilated veins located in the left retroperitoneum (seven left gonadal, seven inferior mesen­ teric, and two left ascending lumber veins)in the viewpoints of the size, location and relation with the sur­ rounding structures Bilateral inferior vena cava (IVC) may be asynunetric and the left IVC may be smaller than other retroperitoneal veins with a round contour. The left IVC was located anterior to the spinal body and corre­ sponded with contralateral vena cava in the anteroposterior plane. The gonadal vein was located anterior or anterolateral side of the psoas and always crossed the ureter. Most of the inferior mesenteric vein showed simi lar location to the opposite site of .the vena cava in the anterolateral side of the psoas muscle, medial to the left ureter without crossing. The left ascending lumbar vein was similarly located to the left vena cava but dilat­ ed in a short segment. It is required to trace the vessel upward and downward and observe its continuity for correct differentiation. If it is impossible, some differential points suggested in the results of our study will be helpful for distinguishing them. Index Words: Venae Cavae, abnormalities 982.14 Venae Cavae, CT Veins, CT tion or operation. Generally these vessels can INTRODUCTION be distinguished by observing the ir caudal andj or cranial continuities on the consecutive CT Bilateral inferior vena cava (IVC) is a rela­ sections. But, the paucity of the retroperitoneal tively rare anomalous condition, which can be fat, small size of the vessel and other factors correctly diagnosed on the basis of computed may interfere with tracing the vessel (1, 5, 6). tomography (CT) findings without angiography We present CT findings of this anomalyand (1-4). Other retroperitoneal veins may be dilat­ dilated veins and figure out some differential ed in certain circumstances such as portal points among these structures with a brief hypertension or postpartum state and located at review of anatomy. the left side of the aorta similar to the left IVC (5-10). The recognition of these venous struc­ MATERIALS AND METHODS tures and their differentiation are important to radiologists and surgeons for imaging, interven- We performed 557 abdominal CT scans for 이 논문은 199 3 년 1 월 13 일 접수하여 199 3 년 4 월 20 일에 채 택되 었음 . Received January 13, Accepted April 20, 1993 - 1187 - Journal of Korean Radiological Society 1993; 29 (6) 1187~ 1193 a year by Philips 305 CT system, and experi­ was discriminated anatomically by the observa­ enced five patients (six CT examinations) with tion of its cephalad and caudad continuities in bilateral 1VC. All patients were examined after consecutive CT section. The scans were exclud­ intravenous injection of contrast material. Diag­ ed when a correct anatomic differentiation was nosis was made on the basis of CT findings as difficult on the basis of CT findings. The size described in the literatures (1 -3). 1n five pairs and location of the veins in the infrarenal levels of bilateral 1VC, we measured the diameter of were estimated by the same method as in the the vessel at the mid portion of the renal vein left 1VC. and 1VC bifurcation by the optical magnifica­ tion of hard copies. We also assessed the loca­ RESULT tion of the left 1VC in its whole length. The right 1VC was used as a reference in the The clinical and CT findings of five patients anteroposterior (AP) plane, and the spine and with double 1VC are summarized in Table 1. psoas muscle in the mediolateral (ML) plane. Every left vena cava joined with the right coun­ We also observed the relative location of the terpart at the renal vein level through a vascu­ vessel to left ureter. lar struc다cture after joining with the left renal Additionally, we selected the scans that vein. The size of the veins was variable (half to showed the vein of a diameter over 5mm in the almost same as that of the right 1VC) and the left side of the abdominal aorta that were verti­ shape was oval or round. The smallest one (No cally oriented similar to left 1VC after reviewing 5) was measured about 1 cm. The veins were another 200 abdominal CT scans. Each vein located just anterior to the spinal body and at Table 1. Clinical Findings and CT Measurement of Bilateral Inferior Vena Cava Case No Age/ Sex Clinical diagnosis Right vena cava left vena cava Short* long'" Short" Long'"‘ 38/ F Stomach cancer 16 17 11 16 2 48/ M Lymphoma 17 20 11 13 3 64/ M Hepatoma 14 16 10 13 4 61 / M Stomach cancer 13 18 12 20 5 73/ F CBD cancer 19 21 10 11 * Short diameter in rrùllimeters ** Long diameter in rrùllimeters a b c Fig. 1. Bilateral inferior vena cava a. At level of the left renal vein, note bulging contou1' at the joint of the left vena cava and left renal vein (arrows) b. On 10we 1' scan, a pai1' of venae cavae 1'un on each side of the ao 1'ta. c. Each vena cava connects with its own common iliac vein - 1188 - Kyung Joo Park, et al : CT Findings of Bilateral Inferior Vena Cava a b c Fig. 2. Asymmetric bilateral inferior vena cava a,b,c. At the same level as Fig. 1. the left vena cava is quite smaller than the right, with a round contour Fig. 3. Left gonadal vein. a. Dilated left gonadal vein joins with the left renal vein with a bulg­ ing contour (arrows) b,c. The vein (arrows) located at the anterolateral side of the psoas muscle crosses the left ureter (open arrows) from medial to later­ al side as it descends. d. Below caval bifurction, the vein a b (arrow) descends along the psoas, far-lateral to the left ureter (open arrow). c d the same position as the right counterpart in eters from the medial (n = 5) and anterior (n = the AP plane (Fig. 1, 2). 1) to the later띠 side as they descended (Fig. 3). The 16 dilated retroperitoneal veins chosen In one case, the left ureter was not found due by the criteria were 7 left gonadal, 7 inferior‘ to previous left nephrectomy. mesenteric, and 2 left ascending lumbar veins. The size of the IMV (n = 7) ranged from 0.6 The left gonadal veins (n = 7) had the diameters to 0.8cm and they were round in contour. Five of 0.6 to 1. 1cm and were round in contour. cases demonstrated the joining with the splenic Five were anterior (n = 4) and lateral (n= 1) to vein, however, in two cases the segments anteri­ the psoas muscle in the ML plane. Two were or to the left renal vein were shown without located anterior to the psoas muscle at the cau­ further cephalad continuity. The location of the dal level, and gradually moved laterally to the vein below the left renal vein in the ML plane muscle as they ascended. In the AP plane, four was somewhat variable. Four were anterior, two cases were located posteriorly to the IVC. Two were lateral to the psoas muscle, and one was were at the same level of IVC, and one was ini­ anterior to the spinal body. In the AP plane, tially at the same level, and moved posteriorly most (n = 6) were matched with the IVC except as they descended. All the veins crossed the ur- one case located anteriorly. Most (n = 5) of the 1189 - Journal of Korean Rad iological Society 1993; 29 (6) : 1187 ~ 1 193 Fig. 4. Inferior mesentenc vein. a. At the cephalic end, the vein (arrows) meets with the splenic vein or SMV (thin arrow). b. The vein (arrow) is typic와 ly 10- cated anterior to the left renal vein and behind or to left of the duodenojejunal flexure (이). c. On lower sections , the vein (aπow) is located quite similar to a the left inferior vena cava, but an­ tenor to the psoas muscJ e, runs medial side of the left ureter (open arrow). d. Below caval bifurcation, it is di­ vided into two branches (arrows) still medial to the left ureter (open arrow) c d Fig. 5. Left ascending lumbar vems a,b. At infrarenal level, the loca­ tion and the shape of the vein (arrows) is veη similar to the left inferior vena cava. It ascends pos­ terior to the left renal vein (rv) c,d. ln another case, the vein (arrows) joins with the inferior vena cava (v) behind the aorta. En­ a b larged precaval lymph nodes (n) show lesser enhancement c d veins were located medial to the ureter in its round or oval-shaped and dilated in short seg­ whole visualized length (Fig. 4). One crossed ments. They were located anterior to the psoas the ureter from lateral to medial side as it de­ muscle or to the spine in the ML plane and scended. In one case, the left ureter was not posterior or the same level to the IVC in the opacified due to autonephrectomized kidney by AP plane.
Load more

Recommended publications
  • Vessels and Circulation
    CARDIOVASCULAR SYSTEM OUTLINE 23.1 Anatomy of Blood Vessels 684 23.1a Blood Vessel Tunics 684 23.1b Arteries 685 23.1c Capillaries 688 23 23.1d Veins 689 23.2 Blood Pressure 691 23.3 Systemic Circulation 692 Vessels and 23.3a General Arterial Flow Out of the Heart 693 23.3b General Venous Return to the Heart 693 23.3c Blood Flow Through the Head and Neck 693 23.3d Blood Flow Through the Thoracic and Abdominal Walls 697 23.3e Blood Flow Through the Thoracic Organs 700 Circulation 23.3f Blood Flow Through the Gastrointestinal Tract 701 23.3g Blood Flow Through the Posterior Abdominal Organs, Pelvis, and Perineum 705 23.3h Blood Flow Through the Upper Limb 705 23.3i Blood Flow Through the Lower Limb 709 23.4 Pulmonary Circulation 712 23.5 Review of Heart, Systemic, and Pulmonary Circulation 714 23.6 Aging and the Cardiovascular System 715 23.7 Blood Vessel Development 716 23.7a Artery Development 716 23.7b Vein Development 717 23.7c Comparison of Fetal and Postnatal Circulation 718 MODULE 9: CARDIOVASCULAR SYSTEM mck78097_ch23_683-723.indd 683 2/14/11 4:31 PM 684 Chapter Twenty-Three Vessels and Circulation lood vessels are analogous to highways—they are an efficient larger as they merge and come closer to the heart. The site where B mode of transport for oxygen, carbon dioxide, nutrients, hor- two or more arteries (or two or more veins) converge to supply the mones, and waste products to and from body tissues. The heart is same body region is called an anastomosis (ă-nas ′tō -mō′ sis; pl., the mechanical pump that propels the blood through the vessels.
    [Show full text]
  • SŁOWNIK ANATOMICZNY (ANGIELSKO–Łacinsłownik Anatomiczny (Angielsko-Łacińsko-Polski)´ SKO–POLSKI)
    ANATOMY WORDS (ENGLISH–LATIN–POLISH) SŁOWNIK ANATOMICZNY (ANGIELSKO–ŁACINSłownik anatomiczny (angielsko-łacińsko-polski)´ SKO–POLSKI) English – Je˛zyk angielski Latin – Łacina Polish – Je˛zyk polski Arteries – Te˛tnice accessory obturator artery arteria obturatoria accessoria tętnica zasłonowa dodatkowa acetabular branch ramus acetabularis gałąź panewkowa anterior basal segmental artery arteria segmentalis basalis anterior pulmonis tętnica segmentowa podstawna przednia (dextri et sinistri) płuca (prawego i lewego) anterior cecal artery arteria caecalis anterior tętnica kątnicza przednia anterior cerebral artery arteria cerebri anterior tętnica przednia mózgu anterior choroidal artery arteria choroidea anterior tętnica naczyniówkowa przednia anterior ciliary arteries arteriae ciliares anteriores tętnice rzęskowe przednie anterior circumflex humeral artery arteria circumflexa humeri anterior tętnica okalająca ramię przednia anterior communicating artery arteria communicans anterior tętnica łącząca przednia anterior conjunctival artery arteria conjunctivalis anterior tętnica spojówkowa przednia anterior ethmoidal artery arteria ethmoidalis anterior tętnica sitowa przednia anterior inferior cerebellar artery arteria anterior inferior cerebelli tętnica dolna przednia móżdżku anterior interosseous artery arteria interossea anterior tętnica międzykostna przednia anterior labial branches of deep external rami labiales anteriores arteriae pudendae gałęzie wargowe przednie tętnicy sromowej pudendal artery externae profundae zewnętrznej głębokiej
    [Show full text]
  • A Case of the Bilateral Superior Venae Cavae with Some Other Anomalous Veins
    Okaiimas Fol. anat. jap., 48: 413-426, 1972 A Case of the Bilateral Superior Venae Cavae With Some Other Anomalous Veins By Yasumichi Fujimoto, Hitoshi Okuda and Mihoko Yamamoto Department of Anatomy, Osaka Dental University, Osaka (Director : Prof. Y. Ohta) With 8 Figures in 2 Plates and 2 Tables -Received for Publication, July 24, 1971- A case of the so-called bilateral superior venae cavae after the persistence of the left superior vena cava has appeared relatively frequent. The present authors would like to make a report on such a persistence of the left superior vena cava, which was found in a routine dissection cadaver of their school. This case is accompanied by other anomalies on the venous system ; a complete pair of the azygos veins, the double subclavian veins of the right side and the ring-formation in the left external iliac vein. Findings Cadaver : Mediiim nourished male (Japanese), about 157 cm in stature. No other anomaly in the heart as well as in the great arteries is recognized. The extracted heart is about 350 gm in weight and about 380 ml in volume. A. Bilateral superior venae cavae 1) Right superior vena cava (figs. 1, 2, 4) It measures about 23 mm in width at origin, about 25 mm at the pericardiac end, and about 31 mm at the opening to the right atrium ; about 55 mm in length up to the pericardium and about 80 mm to the opening. The vein is formed in the usual way by the union of the right This report was announced at the forty-sixth meeting of Kinki-district of the Japanese Association of Anatomists, February, 1971,Kyoto.
    [Show full text]
  • Gonadal Vein Embolization Diagnosing and Treating Pelvic Congestion Syndrome
    COVER STORY Gonadal Vein Embolization Diagnosing and treating pelvic congestion syndrome. BY SANDEEP BAGLA, MD ifteen percent of all outpatient gynecologic visits and 30% of patients who present with pelvic pain are secondary to pelvic congestion syndrome (PCS). Unfortunately, this disease is often overlooked, with Fpatients frequently undergoing an exhaustive evaluation before being diagnosed with PCS. Pelvic congestion with varices was first described more than 150 years ago, and the symptoms were considered psychosocial more than 50 years ago;1 even still, there are often delays in diagnosis because general practitioners are not aware of the syn- drome and typically refer patients to psychologists or other counselors. The underlying pathophysiology of PCS was first described around the same time, with further anatomical understanding developed in more recent decades. Negative psychosocial associations with the term pelvic congestion syndrome has led to pelvic venous insufficiency being the preferred term for describing the underlying pathophysiol- ogy of the condition.1 Although the etiology of PCS is poorly understood, the primary abnormality is the absence of functioning valves in the ovarian or internal iliac vein branches. This likely congenital absence of valves or hereditary predisposition is the most common explanation. The condition is wors- ened with each successive pregnancy due to increased blood flow and hormonal fluctuations. Subclinical thrombosis of these veins may further contribute to the development of the syndrome. Other less common etiologies are secondary to uterine malposition and Figure 1. Coronal T2 short TI inversion recovery image nutcracker syndrome (eg, left renal vein compression depicts parauterine varices (dashed white arrow) and labial between the aorta and the superior mesenteric artery).
    [Show full text]
  • Congenital Inferior Vena Cava Anomalies: a Review of Findings at Multidetector Computed Tomography and Magnetic Resonance Imaging
    Yang C et al. CongenitalREVIEW inferior ARvenaTICLE cava anomalies Congenital inferior vena cava anomalies: a review of findings at multidetector computed tomography and magnetic resonance imaging* Anomalias congênitas da veia cava inferior: revisão dos achados na tomografia computadorizada multidetectores e ressonância magnética Catherine Yang1, Henrique Simão Trad2, Silvana Machado Mendonça3, Clovis Simão Trad4 Abstract Inferior vena cava anomalies are rare, occurring in up to 8.7% of the population, as left renal vein anomalies are considered. The inferior vena cava develops from the sixth to the eighth gestational weeks, originating from three paired embryonic veins, namely the subcardinal, supracardinal and postcardinal veins. This complex ontogenesis of the inferior vena cava, with multiple anastomoses between the pairs of embryonic veins, leads to a number of anatomic variations in the venous return from the abdomen and lower limbs. Some of such variations have significant clinical and surgical implications related to other cardiovascular anomalies and in some cases associated with venous thrombosis of lower limbs, particularly in young adults. The authors reviewed images of ten patients with inferior vena cava anomalies, three of them with deep venous thrombosis. The authors highlight the major findings of inferior vena cava anomalies at multidetector computed tomography and magnetic resonance imaging, correlating them the embryonic development and demonstrating the main alternative pathways for venous drainage. The knowledge on the inferior vena cava anomalies is critical in the assessment of abdominal images to avoid misdiagnosis and to indicate the possibility of associated anomalies, besides clinical and surgical implications. Keywords: Inferior vena cava; Congenital abnormalities; Venous thrombosis. Resumo Anomalias da veia cava inferior são incomuns, ocorrendo em até 8,7% da população, quando consideradas as anoma- lias da veia renal esquerda.
    [Show full text]
  • Liquid and Solid Embolic Agents in Gonadal Veins
    Journal of Clinical Medicine Review Liquid and Solid Embolic Agents in Gonadal Veins Francesco Tiralongo 1,* , Giulio Distefano 1 , Monica Palermo 1 , Antonio Granata 2, Francesco Giurazza 3, Francesco Vacirca 1, Stefano Palmucci 1 , Massimo Venturini 4 and Antonio Basile 1 1 Radiology Unit I, Department of Medical Surgical Sciences and Advanced Technologies “GF Ingrassia” –University Hospital “Policlinico-San Marco”, University of Catania, Via Santa Sofia n◦ 78, 95123 Catania, Italy; [email protected] (G.D.); [email protected] (M.P.); [email protected] (F.V.); [email protected] (S.P.); [email protected] (A.B.) 2 Nephrology and Dialysis Unit, “Cannizzaro” Hospital, 95123 Catania, Italy; [email protected] 3 Interventional Radiology Department, Cardarelli Hospital of Naples, 80131 Naples, Italy; [email protected] 4 Department of Diagnostic and Interventional Radiology, Circolo Hospital, Insubria University, 21100 Varese, Italyl; [email protected] * Correspondence: [email protected] Abstract: Male varicocele and pelvic congestion syndrome (PCS) are common pathologies with high predominance in young patients, having a high impact on the quality of life and infertility. Lately, the use of different endovascular embolization techniques, with various embolizing agents, shows good technical results and clinical outcomes. With the aim of presenting the “state of the art” of endovascular techniques for the treatment of male varicocele and PCS, and to discuss the performance of the different embolic agents proposed, we conducted an extensive analysis of the relevant literature and we reported and discussed the results of original studies and previous meta-analyses, providing an updated guide on this topic to clinicians and interventional radiologists.
    [Show full text]
  • Unusual Termination of the Right Testicular Vein
    CASE REPORT Anatomy Journal of Africa. 2016. Vol 5 (2): 746 - 749 UNUSUAL TERMINATION OF THE RIGHT TESTICULAR VEIN Dawit Habte Woldeyes 1, Mengstu Desalegn Kiros 1 1Department of Human Anatomy, College of Medicine and Health sciences, Bahir Dar University, po.box 79. E-mail: [email protected]. Tel. +251938221383. Fax. +251582202025 ABSTRACT The testicular veins are formed by the veins emerging from the testis and epididymis forming the pampiniform venous plexus. The right testicular vein drains into inferior vena cava and the left testicular vein to the left renal vein. Testicular veins display a great variability with regard to their number, course and sites of termination. Awareness of the possible variations of gonadal vessels is necessary for adequate surgical management. Key words: Testicular vein, Termination, Inferior vena cava, Renal vein. INTRODUCTION The testicular veins are formed by the veins interventional radiologic procedures and emerging from the testis and epididymis urologic operations increase, awareness of forming the pampiniform venous plexus. The the possible variations of gonadal vessels is right testicular vein drains into inferior vena necessary for adequate surgical management in cava and the left testicular vein to the left renal the aforementioned specialties (Punita and vein (Moore et al. 2010; Punita and Surinder Surinder 2011; Bandopadhyay et al 2009). 2011; Nayak et al. 2013). Certain vascular and developmental anomalies of kidneys can be associated with variations in Testicular veins display a great variability with the origin and course of the gonadal vessels. regard to their number, course and sites of These anomalies are explained by the termination; the pathological dilated embryological development of both of these pampiniform plexus veins known as organs from the intermediate mesoderm of varicocele could be attributed to testicular the mesonephric crest.
    [Show full text]
  • Embolization of the Ovarian and Iliac Veins for Pelvic Congestion Syndrome
    UnitedHealthcare® Commercial Medical Policy Embolization of the Ovarian and Iliac Veins for Pelvic Congestion Syndrome Policy Number: 2021T0574K Effective Date: May 1, 2021 Instructions for Use Table of Contents Page Related Commercial Policy Coverage Rationale ........................................................................... 1 • Surgical and Ablative Procedures for Venous Definitions ........................................................................................... 1 Insufficiency and Varicose Veins Applicable Codes .............................................................................. 2 Description of Services ..................................................................... 2 Community Plan Policy Clinical Evidence ............................................................................... 2 • Embolization of the Ovarian and Iliac Veins for Pelvic U.S. Food and Drug Administration ................................................ 4 Congestion Syndrome References ......................................................................................... 5 Policy History/Revision Information................................................ 6 Instructions for Use ........................................................................... 6 Coverage Rationale Embolization of the Ovarian Vein or Internal Iliac Vein is unproven and not medically necessary for treating Pelvic Congestion Syndrome due to insufficient evidence of efficacy. Definitions Embolization: A procedure that uses particles, such as tiny
    [Show full text]
  • Endovascular Stenting of Ascending Lumbar Veins for Refractory Inferior Vena Cava Occlusion
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector From the American Venous Forum Endovascular stenting of ascending lumbar veins for refractory inferior vena cava occlusion Christopher T. Healey, MD, Neil Halin, DO, and Mark Iafrati, MD, Boston, Mass Chronic inferior vena cava (IVC) occlusion is a debilitating disease process. Recently, endovascular techniques have been described using progressive balloon dilatation and stenting to treat IVC occlusion with reasonable success. We present two cases of endovascular dilatation and stenting of the ascending lumbar vein. This technique provided good early relief of symptoms with ulcer healing, decreased swelling, and decreased pain. To our knowledge this is the first report of endovascular therapy of IVC occlusion via stenting of the ascending lumbar vein. This technique may provide a feasible treatment option when the occluded IVC cannot be reopened. (J Vasc Surg 2006;44:879-81.) Inferior vena cava (IVC) occlusion is a rare condition Next, the entire tract from the iliac to the SVC was crossed stemming from a variety of causes. Symptoms vary, de- with a 260-cm Nitrex guidewire (EV3, Plymouth, Minn) and pending on the adequacy of collateral drainage, but may predilated to 8 mm. Two 8-mm ϫ 15-cm and one 8-mm ϫ 10-cm include pain, edema, skin changes, venous stasis ulcers, and Viabahn stent-grafts (WL Gore & Assoc, Newark, Del) were weakness. Historically, medical treatment (anticoagulation, deployed. The entire tract was again dilated to 8 mm. Imaging at elevation, compression garments) has been the first line of the conclusion of the procedure demonstrated patency from the therapy.
    [Show full text]
  • Current Concepts ⅢⅢⅢⅢⅢⅢⅢⅢⅢⅢⅢⅢⅢⅢ Focal Neurological Manifestations Following Aberrant Central Venous Catheter Placement
    Current Concepts nnnnnnnnnnnnnn Focal Neurological Manifestations Following Aberrant Central Venous Catheter Placement Vigna Rajan, MD On day 14, infant B acutely developed sustained tonic-clonic Feizal Waffarn, MD movements affecting the lower extremities; these movements were clinically diagnosed as focal seizures and were treated with an anti- An infant developed focal tonic clonic movements of both lower limbs convulsant. A lumbar puncture performed to rule out meningitis 3 while receiving total parenteral nutrition through a left saphenous yielded cloudy fluid consisting of 34,114/mm red blood cells and 3 percutaneous central venous catheter. Radiographic studies using a 749/mm white blood cells with 3% lymphocytes and 97% poly- contrast confirmed that the catheter tip was located in the ascending morphs. The glucose and protein content of the fluid was 3943 mg/dl lumbar vein in close proximity to the epidural space. Withdrawal of the and 127 mg/dl, respectively. Blood and lumbar puncture fluid cul- catheter abated all clinical symptoms. This case emphasizes the need to tures grew coagulase-negative staphylococcus sensitive to vancomy- 3 confirm central venous catheter placement and illustrates yet another cin. A repeat lumbar puncture specimen showed 50,250/mm red 3 risk associated with the infusion of parenteral alimentation. blood cells, 1,515/mm white blood cells, and 7,348 mg/dl glucose. There was a continuous leakage of serous fluid at the site of the lum- bar puncture, with a glucose level of .800 mg/dl. Serum glucose levels remained between 80 and 120 mg/dl during this period. A lat- Central venous access for long-term total parenteral nutrition eral radiograph of the abdomen and pelvis showed the catheter loca- (TPN) is a standard practice in neonatology, and associated com- tion posterior to the lumbar vertebral column.
    [Show full text]
  • A Study on Numeric Variation of Gonadal Veins in Eastern India: Embryological Aspect and Its Application
    IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 1 Ver. 16 January. (2018), PP 72-74 www.iosrjournals.org A Study on Numeric Variation of Gonadal Veins in Eastern India: Embryological Aspect and Its Application Dr Soumedhik Dey1, Dr Banani Kundu2, Dr Abhijit Bhakta3 1Dr Soumedhik Dey ,Assistant professor, Dept of Anatomy, Nil Ratan Sircar medical college and hospital ,Kolkata 2Dr Banani Kundu , Assistant professor, Dept of Anatomy. R. G. Kar Medical College and hospital, Kolkata 3Dr Abhijit Bhakta ,Associate Professor, Dept of Anatomy, Nil Ratan Sircar Medical College and Hospital,Kolkata. Corresponding Author: Dr Soumedhik Dey Abstract Introduction : The gonadal veins are anatomically asymmetric. They are single in number on each side but they drain differently. Aim : Our aim is to analysis the percentage of dual gonadal veins on both sides. Material And Method: We explore 67 well embalmed bodies during our routine undergraduate and post graduate teaching at various medical colleges over a period of three and a half year. Result : In our present study, male is to female ratio was found 46 :21. Though we do not found any variation in ovarian veins but in the 2 cases(4.34%)left sided testicular vein shows duplication and both the veins drain into left renal vein. Discussion : Duplication on left side may be due to the alteration in anastomotic channel of postcardinal , supracardinal and subcardinal veins. Conclusion : The gonadal vein present in numeric variation and its knowledge is essential during various renal and gonadal surgical operations.
    [Show full text]
  • Left Gonadal Vein Thrombosis in a Patient with COVID-19-Associated­ Coagulopathy Maedeh Veyseh,1 Prateek Pophali,1 Apoorva Jayarangaiah,2 Abhishek Kumar2,3
    BMJ Case Rep: first published as 10.1136/bcr-2020-236786 on 7 September 2020. Downloaded from Unusual presentation of more common disease/injury Case report Left gonadal vein thrombosis in a patient with COVID-19- associated coagulopathy Maedeh Veyseh,1 Prateek Pophali,1 Apoorva Jayarangaiah,2 Abhishek Kumar2,3 1Medicine, Jacobi Medical SUMMARY CASE PRESENTATION Center, Bronx, New York, USA COVID-19 disease is a viral illness that predominantly A- 52- year old postmenopausal woman, with no 2 Hematology and Oncology, causes pneumonia and severe acute respiratory distress known medical history, presented to our hospital Jacobi Medical Center, Bronx, syndrome. The endothelial injury and hypercoagulability with sudden onset of severe sharp right upper quad- New York, USA rant abdominal pain for 2 days. She described the 3Hematology and Oncology, secondary to the inflammatory response predisposes Yeshiva University Albert severely ill patients to venous thromboembolism. The pain to be unrelated to food and not associated with Einstein College of Medicine, exact mechanism of hypercoagulability is still under any other gastrointestinal (GI)- related symptoms. Bronx, New York, USA investigation, but it is known to be associated with poor She denied recent fevers, cough or upper respi- prognosis. The most common thrombotic complication ratory tract infection symptoms. She was afebrile Correspondence to reported among these patients is pulmonary embolism. (temp 97.7°F), pulse rate 93 beats/min, respiratory Dr Abhishek Kumar; To our knowledge, gonadal vein thrombosis is an rate 22/min and oxygen saturation was 94% on kumara20@ nychhc. org 2 uncommon phenomenon that has not been reported room air, body mass index 29 kg/m .
    [Show full text]