Anomalías de vena cava inferior: revisión e implicaciones quirúrgicas <span class="so-article-trans-title" dir="auto"> Translated title: Inferior vena cava anomalies: review and surgical considerations </span>

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Abstract

Resumen Las anomalías de vena cava inferior (VCI) son el resultado de alteraciones en las diferentes etapas de un complejo proceso embrionario. A pesar de ser entidades poco frecuentes, con escasa o nula repercusión clínica y usualmente reportadas a partir de hallazgos incidentales, su detección es de gran importancia debido a las repercusiones clínicas y quirúrgicas asociadas con su presencia. Las alteraciones hemodinámicas generadas por estas variantes anatómicas constituyen factores predisponentes para el desarrollo de otras patologías concomitantes que requerirán un tratamiento específico. Tanto la falta de conocimiento de estas malformaciones vasculares o los errores diagnósticos relacionados pueden generar consecuencias graves con resultados imprevisibles. Nuestro objetivo es realizar una revisión anatómica y funcional de esta patología, y la importancia de un certero diagnóstico e implicaciones clínico-quirúrgicas.

Translated abstract

Abstract Congenital anomalies of the inferior vena cava (IVC) are the result of alterations in the different stages of a complex embryonic process. Despite being uncommon, with little or no symptomatology and usually reported from incidental findings, their diagnosis is of great importance due to the clinical and surgical implications associated. The hemodynamic changes caused by these anatomical variants are predisposing factors for the development of other concomitant diseases that require a specific treatment. The lack of knowledge or diagnostic errors of these vascular malformations may cause serious consequences with unpredictable results. Our objective is to carry out a review of the anatomical/hemodynamic knowledge of this pathology and the importance of its diagnosis and clinical-surgical implications.

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Venous thrombosis: a multicausal disease

FR Rosendaal (1999)

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Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings.

Zafer Koc, Levent Oguzkurt (2007)

To present the prevalence, clinical, and imaging findings of interruption or congenital stenotic lesions of the inferior vena cava (IVC), associated malformations, and their clinical relevance. Between March 2004 and March 2006, 7972 patients who had undergone consecutive routine abdominal multidetector row computed tomography were analyzed for interruption or stenotic lesion of the IVC. Prevalence of interruption (n=8) or congenital stenosis (n=4) of the IVC occurred in 12 (0.15%) of 7972 patients. Four patients with interruption and four patients with congenital stenosis of the IVC were symptomatic with DVT (n=4), leg swelling (n=4), leg pain (n=2), lower extremity varices (n=2), hepatic vein thrombosis (n=1), and hematochezia (n=1). All four of the asymptomatic patients were from the interruption group, and these patients had interrupted IVC with well-developed azygos/hemiazygos continuation. Eight symptomatic patients did not have a well-developed azygos/hemiazygos continuation, and drainage of lower extremity was mainly from collateral veins. Additional findings in eight symptomatic patients were abdominal venous collaterals (n=8), venous aneurysm (n=2), lower extremity varices (n=2), varicocele (n=2), and pelvic varices (n=1). Interruption or stenosis of the IVC are rare on routine abdominal CT examinations and may cause different clinical findings depending on the variant drainage patterns or collaterals. Interrupted IVC is commonly asymptomatic if associated with well-developed azygos/hemiazygos continuation, whereas commonly symptomatic if well-developed azygos/hemiazygos continuation is not present.