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Isolated bilateral external iliac vein aplasia
Deepali Onkar1, Prashant Onkar, Kajal Mitra
1NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, India. drdeepalionkar@yahoo.com
Surgical and Radiologic Anatomy : SRA
|June 26, 2012
Summary
This case study highlights a rare venous anomaly in an 11-year-old girl, presenting with prominent superficial abdominal and thoracic veins. The investigation revealed an unusual venous return pathway from the lower limbs due to absent external iliac veins.
Area of Science:
- Vascular Surgery
- Pediatric Cardiology
- Medical Imaging
Background:
- Klippel-Trenaunay syndrome is a congenital vascular malformation characterized by nevus, limb hypertrophy, and venous malformations.
- Superficial venous abnormalities can present in various forms, sometimes indicating underlying complex venous system anomalies.
- Congenital absence or hypoplasia of deep venous structures is a rare but significant finding in pediatric vascular cases.
Observation:
- An 11-year-old female presented with prominent superficial abdominal and thoracic veins since birth.
- A unique superficial venous network extended from the inguinal regions to the umbilical and right supraclavicular areas.
- Key features of Klippel-Trenaunay syndrome, such as nevus and limb edema, were notably absent in this patient.
Findings:
- Radiological imaging demonstrated the absence of both external iliac veins.
- Venous return from the lower limbs was rerouted through the superficial venous system, ultimately draining into the right subclavian vein.
- Surgical exploration confirmed the non-identification of the external iliac veins, validating the radiological findings.
Implications:
- This case illustrates an atypical presentation of venous malformation, emphasizing the importance of comprehensive vascular assessment in pediatric patients.
- The findings suggest that superficial venous patterns can be crucial indicators of deep venous system anomalies, even in the absence of classic Klippel-Trenaunay syndrome stigmata.
- Understanding such rare venous anomalies is vital for accurate diagnosis, surgical planning, and management of potential complications in pediatric vascular disease.
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