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Absence of right common iliac vein causing suprapubic and scrotal varices in a young athletic man

Saad Balamane1, Peter Brown2, David Zelt2

  • 1Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.

Journal of Vascular Surgery Cases and Innovative Techniques
|November 8, 2021
PubMed

Insights

A young man with painful abdominal and scrotal varices had a rare congenital condition: an atretic right common iliac vein. This venous anomaly created a critical collateral pathway for his right leg.

Area of Science:

  • Vascular Surgery
  • Vascular Medicine
  • Medical Case Reports

Background:

  • Varices and varicoceles can present with significant patient discomfort and diagnostic challenges.
  • Deep venous system anomalies are uncommon but critical considerations in venous disease diagnosis.

Observation:

  • A 26-year-old male presented with persistent, exercise-exacerbated painful abdominal varices and bilateral scrotal varicoceles.
  • Investigations revealed a congenital atresia of the right common iliac vein.
  • Right-to-left collateralization of the femoral and internal iliac veins was identified, forming a crucial venous outflow pathway.

Findings:

  • The venous shunting created suprapubic, pelvic, and gonadal varicosities.
  • These varicosities served as an essential collateral circulation for the right lower extremity.

Implications:

  • This case underscores the importance of considering congenital deep venous anomalies in the differential diagnosis of venous diseases.
  • Heightened vigilance is crucial for managing this patient, particularly concerning future abdominal and urologic procedures.
  • Recognizing such anomalies is vital for preventing complications and ensuring appropriate patient care.

Keywords:
Right common iliac veinVaricosities

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