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Symptomatic abdominal aortic aneurysm with inferior vena cava malposition
D J Evers1, J H M B Stoot, R J Breslau
1Department of Surgery, Haga Hospital, The Hague, The Netherlands. devers@hotmail.com
Acta Chirurgica Belgica
|February 16, 2008
Summary
A patient had unexpected bleeding during surgery for an abdominal aortic aneurysm due to a rare left-sided inferior vena cava. Careful review of CT scans is crucial to identify such venous anomalies before surgery.
Area of Science:
- Vascular Surgery
- Anatomical Variations
- Medical Imaging
Background:
- Abdominal aortic aneurysms (AAAs) are a significant vascular condition requiring surgical intervention.
- Surgical repair of AAAs carries inherent risks, including significant hemorrhage.
- Anatomical variations, particularly venous anomalies, can complicate surgical procedures.
Observation:
- A 66-year-old woman presented with a symptomatic AAA and underwent transperitoneal surgical repair.
- Intraoperative findings revealed a previously undiagnosed left-sided inferior vena cava (IVC).
- Preoperative abdominal computed tomography (CT) failed to identify this retroperitoneal venous malformation.
Findings:
- The presence of a left-sided IVC represents a rare congenital venous anomaly.
- Undetected venous anomalies can lead to unexpected intraoperative hemorrhage during aortic reconstruction.
- This case highlights a discrepancy between preoperative imaging and intraoperative findings.
Implications:
- Systematic and meticulous review of preoperative contrast-enhanced CT scans is essential for identifying retroperitoneal venous anomalies.
- Enhanced preoperative awareness of such anomalies can improve surgical planning and patient safety.
- Early detection of venous variations can mitigate the risk of severe intraoperative complications like hemorrhage.
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