Venous anomalies encountered in aortoiliac surgery
E. D. Baldridge Jr and A. J. Canos
Department of Surgery, Good Samaritan Hospital, Cincinnati, OH 45220.
Reconstructive procedures of the aortoiliac system are extremely common.
Aside from ruptured aneurysms, most severe intraoperative hemorrhage is due
to venous injuries. The ability to recognize and manage venous anomalies is
essential. This article presents a review of major venous anomalies
including (1) transposition of the inferior vena cava, (2) double vena
cava, (3) retroaortic left renal vein, (4) circumaortic renal collar, and
(5) preaortic iliac venous confluence. Embryologic development, operative
recognition, and techniques of operative management are discussed. A case
report is presented in which an anomaly similar to a preaortic iliac
confluence was discovered during aortic reconstruction for a ruptured
abdominal aortic aneurysm. This case differs from previously reported cases
of preaortic iliac confluence in that the right common iliac vein persisted
in its course anterior to the right common iliac artery.
