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Because the inferior vena cava is located to the right of the midline, drainage of the tributaries is not always symmetrical. The other two main veins, the middle and left hepatic veins, usually drain into the inferior vena cava as a common trunk. Anatomy/CV. Retroaortic left renal vein: The renal vein crosses posterior to the aorta to join the IVC. The portal vein gets the subsequent tributaries: Splenic vein, a bigger formative tributary. It is retroperitoneal and lies immediately to the right of the aorta. The IVC was to the right of the spine, smaller than normal , and ended abruptly a short distance above the right renal vein at the level of the first lumbar vertebra . 3 Anterior hepatic veins -RHV-MHV-LHV. The proximal right ureter courses posterior to the IVC, emerges to the right of the aorta, and lies anterior to the right iliac vessel. In 63% of cases betwe … Our engaging videos, interactive quizzes, in-depth articles and HD atlas are here to get you top results faster. The IVC lies between the liver and the diaphragm and cephalad courses medially to enter the right atrium. This image, obtained at portal-venous phase at the level of the left renal vein, shows heterogeneous luminal enhancement due to mixing of the renal vein blood with the inferior IVC blood. I Like To Rise So High Iliac Lumbar Testicular Renal Suprarenal Hepatic vein. The most common IVC anomalies are: (1) left IVC, (2) duplicated IVC, (3) azygos continuation of IVC, (4) circumaortic left renal vein, (5) retroaortic left renal vein, (6) circumcaval or retrocaval ureter, (7) duplicated right renal vein, (8) absence of infrarenal or entire IVC, (9) duplicated IVC with retroaortic right renal vein and hemiazygos continuation of the IVC, and (10) duplication of IVC with retroaortic left renal vein and azygos continuation of the IVC. Knowing the tributaries of the inferior vena cava can be important in the surgical field. The diameter of the main hepatic veins on average 12.3 mm, and back — 4.8 mm. Major tributaries such as the renal and adrenal veins have been studied extensively; however, tributaries of the infra-renal segment of the inferior vena cava (IVC) have not been given much attention. X-ray catheter angiography studies provide limited anatomic information. Note the absence of the intrahepatic IVC and how the hepatic veins drain directly into the right atrium (arrow). The inferior vena cava is a large, valveless, venous trunk that receives blood from the legs, the back, and the walls and contents of the abdomen and pelvis. Examples of this technique include T4-weighted spin echo and single shot T2-weighted imaging (e.g., SSFSE, HASTE), which can provide excellent anatomic assessment almost free of motion artifacts. In this chapter, we will discuss the anatomy and pathology of the IVC, starting with the anatomic variants, then we will review tumoral disease affecting the IVC and finally, we will discuss some liver transplantation and interventions. The left IVC joins the left renal vein, which then crosses anterior to the abdominal aorta and drains into the right IVC (Fig. In human cardiovascular system: Inferior vena cava and its tributaries. The diameter of the main hepatic veins on average 12.3 mm, and back — 4.8 mm. In more complex IVC anomalies, such as duplication of IVC with retroaortic right renal vein and hemiazygos continuation of the IVC or complete absence of the IVC, ultrasonography may be unable to fully delineate all venous connections and CT or MRI may be required. A, Contrast-enhanced CT of the abdomen depicts axial images at the level of the renal veins showing normal location and size of the IVC located to the right of the aorta. 3 formative veins: 2 common iliac veins and the median sacral vein. The latter may join the left common iliac vein. Cystic Gastric Splenic. D, Sagittal MIP reformat shows the azygos (A) continuation of the right IVC and how it connects to the SVC (S) through the azygos arch. Partial or complete absence of IVC: The variants of this anomaly include complete absence of the entire IVC which may include the iliac veins as well and partial absence of IVC with preservation of the suprarenal segment. Hepatic veins. It passes posterior to the diaphragmatic crura, enters the thorax as the azygos vein, and then joins the superior vena cava at the azygos arch. The right inferior vena cava was formed in the usual way by the junction of the right and left common iliac veins, and from thence upward it pursued the ordinary course of the inferior vena cava on the right of the aorta. The right IVC joins the right renal vein, which crosses posterior to the aorta to drain in the left IVC. Occasionally IVC tumors may cause embolism to the pulmonary arteries and produce cardiorespiratory symptoms including chest pain, tachycardia, and dyspnea. Anatomic variants should be diagnosed prior to angiographic procedures in the IVC or otherwise may cause confusion and prolong fluoroscopic time at the time of the intervention, therefore for therapy planning purposes, we recommend the use of CT or MRI. Hepatic portal vein. One of the most common causes of neoplastic invasion of the IVC lumen is the renal cell carcinoma (RCC) that can be seen invading the IVC through the renal vein in 4% to 10% of the cases. and grab your free ultimate anatomy study guide! The IVC receives a number of tributaries including common iliac, lumbar, renal, right adrenal, and hepatic veins. Here, they are connected by the ascending lumbar vein, which runs anterior to the transverse processes of the lumbar vertebrae. The IVC and tributaries were abnormal (Figure 1, Figure 2, Figure 3, Figure 4). The lumbar veins collect blood from the vertebral plexuses near the vertebral column. The liver can be divided into 9 segments and the right hepatic vein drains segments VI and VII as well as parts of segments V and VIII. IVC duplication (infrarenal). Azygos-hemiazygos continuation of the IVC with duplication of the infrarenal IVC. Renal Veins. The current literature consistently describes mortality rates of 50% to 70% for injuries to the superior mesenteric vein… Approximately 5% of patients younger than 30 years with idiopathic deep venous thrombosis show IVC absence on CT. The remaining congenital IVC anomalies are rare. The inferior vena cava (IVC) and major tributary veins are retroperitoneal structures with unique anatomic and developmental characteristics that offer special challenges for clinical and radiologic assessment. FIGURE 110-2 IVC duplication (infrarenal). It communicates with the vertebral venous plexuses. Treatment involves anticoagulation and thrombolytic therapy and may involve liver transplantation if the liver disease progresses to decompensated cirrhosis. Even though the clinical assessment of IVC pathology presents several limitations, the revolutionary advances we have seen in computed tomography (CT) and magnetic resonance imaging (MRI) technology allow us to achieve excellent noninvasive assessments of these structures. The IVC lies between the liver and the diaphragm and cephalad courses medially to … Because MRI does not expose the patient to ionizing radiation, it is possible to acquire multiple series of images postcontrast injection, including axial, coronal, and sagittal planes with different timing for more homogeneous luminal enhancement. Treatment includes anticoagulation therapy and antibiotics. Early in embryogenesis, there are two renal veins for each kidney: ventral and dorsal. It is partially covered anteriorly by the peritoneal membrane. Match. The IVC has a retroperitoneal course within the abdominal cavity. 5-6 branches unite to form the main Renal Veins The renal veins are anterior to the renal arteries on either side of the abdomen. Treatment involves surgical intervention such as left renal vein transposition, where the left renal vein is moved in order to cease the compression, or a nephrectomy, where all or part of the kidney is removed. 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