Giant renal vein aneurysm.

Area of Science:

• Vascular Surgery
• Vascular Imaging
• Vascular Malformations

Background:

• Intra-abdominal venous aneurysms are rare vascular anomalies.
• Diagnosis often occurs incidentally in asymptomatic patients.
• Limited data exists on their natural history and management.

Observation:

• A 37-year-old asymptomatic male incidentally found to have intra-abdominal venous aneurysms.
• Venography revealed an absent inferior vena cava segment, leading to a right renal vein aneurysm (4.4 cm), dilated common iliac veins, and left external iliac vein aneurysm.
• Robust collateralization was noted, suggesting adaptation to the venous anomaly.

Findings:

• The patient's venous aneurysms were associated with an inferior vena cava anomaly.
• Serial imaging demonstrated stability of the aneurysms over time.
• Conservative management was selected due to limited natural history data and surgical complexities.

Implications:

• This case highlights the importance of recognizing rare venous anomalies.
• Serial imaging is a viable management strategy for asymptomatic venous aneurysms.
• Further research is needed to establish optimal treatment guidelines for intra-abdominal venous aneurysms.