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Laparoscopic resection of a cecal carcinoma with a Retzius vein shunt: A case report
Yusuke Kono1, Manabu Yamamoto, Chiharu Yasui
1Department of Surgery, Division of Gastrointestinal and Pediatric Surgery, Faculty of Medicine, Tottori University, Yonago, Japan.
Rationale:
A Retzius shunt between the ileocecal vein and inferior vena cava is rare. To avoid major hemorrhage due to shunt injury, it is essential to evaluate vascular abnormalities on preoperative imaging and to confirm anatomic structures in detail during the operation.
Patient Concerns:
A 71-year-old woman with diabetes and asthma developed anaemia.
Diagnoses:
She was diagnosed with cecal cancer by endoscopy and found to have a venous malformation forming a Retzius shunt from the ileocecal vein to the inferior vena cava on computed tomography.
Intervention:
Laparoscopic ileocecal resection was performed. Colonic mobilization and resection of the ileocecal vessels were performed while minimizing traction on the shunt. After confirming the anatomy, the Retzius shunt was resected without complications.
Outcomes:
The patient experienced an unremarkable postoperative clinical course without complications.
Lessons:
This case involved a rare vascular anomaly associated with colorectal cancer, characterized by an abnormal blood vessel connecting the inferior vena cava and mesenteric veins. When abnormal vessels are detected on preoperative abdominal computed tomography, a Retzius shunt should be considered. Detailed review of the imaging, careful surgical manipulation to avoid shunt damage, and thorough anatomical verification, are important to perform a safe operation.
