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M A Vardar - One of the best experts on this subject based on the ideXlab platform.
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ep980 Gonadal Vein graft after retroaortic left renal Vein injury during paraaortic lymphadenectomy a case report
International Journal of Gynecologic Cancer, 2019Co-Authors: Sevtap Seyfettinoglu, G Khatib, Kucukgoz U Gulec, Ahmet Baris Guzel, Y Bayazit, M A VardarAbstract:Introduction/Background Pelvic and paraaortic lymphadenectomy is a major component of the surgical staging procedure for several gynecological malignancies. The removal of these lymph nodes needs expertise as there is a danger of the major vessel injury during the surgery. In this presentation We would like to report a case in which there was an accidental injury to the left renal Vein during para-aortic lymphadenectomy. Methodology Case: 42 years old patient referred to our clinic with abdominal mass and ascites. After systemic examination, imaging, paracentesis cytology with serous adenocarcinoma and tumor board decision the patient received three cycles of neo-adjuvant chemotherapy followed by interval debulking surgery. During paraaortic lymphadenectomy nearly half of left renal Vein was accidentally ligated and cut with ultrasonic energy device. Left renal Vein was retroaortic. After haemostasis we evaluate the renal circulation and was of the opinion that residual patency of the renal Vein was not adequate for functioning of the left kidney.The stump of the damaged renal Vein was tied, and the venous blood of the left kidney was diverted through an end to side anastomosis of the left Gonadal Vein with the venacava (figure 1). On the post operative period the patient was recovered quickly. Two months later her Tc-99 DMSA and other renal examinations was normal. She is presently well. Results Retroaortic left renal Vein is a normal anatomical variant and its recognition is important in order to avoid complications during retroperitoneal surgery. Management of complications in the literature is various. In our case report, using the Gonadal Vein as an alternative to the left renal Vein saved the patient from nephrectomy. Conclusion Gonadal Vein graft for maintaining renal circulation can be a good alternative management in renal Vein injuries. Disclosure Nothing to disclose.
Eric K. Hoffer - One of the best experts on this subject based on the ideXlab platform.
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Gonadal Vein embolization: treatment of varicocele and pelvic congestion syndrome.
Seminars in interventional radiology, 2008Co-Authors: Mark A. Bittles, Eric K. HofferAbstract:Therapeutic embolization of the Gonadal Veins is performed on male and female patients for different clinical situations using similar techniques. The testicular varicocele is a common clinical problem associated with pain and reduced fertility rates. In women, chronic pelvic pain can be attributed to pelvic congestion syndrome, which is said to result from retrograde flow in incompetent ovarian Veins. Both of these clinical problems respond well to Gonadal Vein embolization. In this article, we review the clinical evaluation, diagnostic workup, and technical aspects of percutaneous intervention of Gonadal Vein embolization. The supporting literature is also reviewed.
Kyoung Hoon Lim - One of the best experts on this subject based on the ideXlab platform.
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Conservative treatment of acute traumatic left renal Vein occlusion: Importance of left Gonadal Vein, case report.
International journal of surgery case reports, 2020Co-Authors: Hyung Jun Kwon, Kyoung Hoon LimAbstract:Isolated acute traumatic renal Vein occlusion is rare. As both kidneys have limited capsular and peripelvic Vein collaterals, acute renal Vein occlusion could lead to renal infarction. However, the left renal Vein has potential collateral pathways through the Gonadal Vein. A 56-year-old woman was transferred to our trauma center after a pedestrian accident. Computed Tomography (CT) with contrast enhancement showed that no delineation of left renal Vein with adjacent retroperitoneal hematoma around renal vessels, but left renal venous flow was being drained through left Gonadal Vein, therefore, left kidney was not congested. Her serum creatinine concentration was normal. We elected to treat her left renal Vein occlusion conservatively because of the collateral pathway into the Gonadal Vein. Collateral pathway of the left renal venous drainage may be well known to urologists or vascular surgeons, but may be unfamiliar to trauma surgeons. Therefore, trauma surgeon's attempts for revascularization of thrombosed left renal Vein may lead to massive bleeding or nephrectomy. Acute left renal Vein occlusion close to the inferior vena cava can result in temporary venous hypertension and congestion followed by complete or nearly complete return of function as collateral Veins enlarge. If the Gonadal Vein is patent, left renal Vein occlusion could be treated conservatively. Copyright © 2020 The Author(s). Published by Elsevier Ltd.. All rights reserved.
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conservative treatment of acute traumatic left renal Vein occlusion importance of left Gonadal Vein case report
International Journal of Surgery Case Reports, 2020Co-Authors: Hyung Jun Kwon, Kyoung Hoon LimAbstract:Abstract Introduction Isolated acute traumatic renal Vein occlusion is rare. As both kidneys have limited capsular and peripelvic Vein collaterals, acute renal Vein occlusion could lead to renal infarction. However, the left renal Vein has potential collateral pathways through the Gonadal Vein. Presentation of case A 56-year-old woman was transferred to our trauma center after a pedestrian accident. Computed Tomography (CT) with contrast enhancement showed that no delineation of left renal Vein with adjacent retroperitoneal hematoma around renal vessels, but left renal venous flow was being drained through left Gonadal Vein, therefore, left kidney was not congested. Her serum creatinine concentration was normal. We elected to treat her left renal Vein occlusion conservatively because of the collateral pathway into the Gonadal Vein. Discussion Collateral pathway of the left renal venous drainage may be well known to urologists or vascular surgeons, but may be unfamiliar to trauma surgeons. Therefore, trauma surgeon’s attempts for revascularization of thrombosed left renal Vein may lead to massive bleeding or nephrectomy. Conclusion Acute left renal Vein occlusion close to the inferior vena cava can result in temporary venous hypertension and congestion followed by complete or nearly complete return of function as collateral Veins enlarge. If the Gonadal Vein is patent, left renal Vein occlusion could be treated conservatively.
Hideki Hirakata - One of the best experts on this subject based on the ideXlab platform.
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Treatment of hepatic encephalopathy by retrograde transcaval coil embolization of an ileal Vein-to-right Gonadal Vein portosystemic shunt
Cardiovascular and interventional radiology, 1997Co-Authors: Akihiro Nishie, Kengo Yoshimitsu, Hiroshi Honda, K. Kaneko, Toshiro Kuroiwa, Tatsuro Fukuya, Hiroyuki Irie, Toshiharu Ninomiya, Takahiro Yoshimitsu, Hideki HirakataAbstract:A 43-year-old non-cirrhotic woman suffered from encephalopathy caused by an extrahepatic portosystemic shunt between the ileal Vein and inferior vena cava via the right Gonadal Vein. Percutaneous transcatheter embolization with stainless steel coils was performed by the retrograde systemic venous approach. Encephalopathy improved dramatically.
Sevtap Seyfettinoglu - One of the best experts on this subject based on the ideXlab platform.
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ep980 Gonadal Vein graft after retroaortic left renal Vein injury during paraaortic lymphadenectomy a case report
International Journal of Gynecologic Cancer, 2019Co-Authors: Sevtap Seyfettinoglu, G Khatib, Kucukgoz U Gulec, Ahmet Baris Guzel, Y Bayazit, M A VardarAbstract:Introduction/Background Pelvic and paraaortic lymphadenectomy is a major component of the surgical staging procedure for several gynecological malignancies. The removal of these lymph nodes needs expertise as there is a danger of the major vessel injury during the surgery. In this presentation We would like to report a case in which there was an accidental injury to the left renal Vein during para-aortic lymphadenectomy. Methodology Case: 42 years old patient referred to our clinic with abdominal mass and ascites. After systemic examination, imaging, paracentesis cytology with serous adenocarcinoma and tumor board decision the patient received three cycles of neo-adjuvant chemotherapy followed by interval debulking surgery. During paraaortic lymphadenectomy nearly half of left renal Vein was accidentally ligated and cut with ultrasonic energy device. Left renal Vein was retroaortic. After haemostasis we evaluate the renal circulation and was of the opinion that residual patency of the renal Vein was not adequate for functioning of the left kidney.The stump of the damaged renal Vein was tied, and the venous blood of the left kidney was diverted through an end to side anastomosis of the left Gonadal Vein with the venacava (figure 1). On the post operative period the patient was recovered quickly. Two months later her Tc-99 DMSA and other renal examinations was normal. She is presently well. Results Retroaortic left renal Vein is a normal anatomical variant and its recognition is important in order to avoid complications during retroperitoneal surgery. Management of complications in the literature is various. In our case report, using the Gonadal Vein as an alternative to the left renal Vein saved the patient from nephrectomy. Conclusion Gonadal Vein graft for maintaining renal circulation can be a good alternative management in renal Vein injuries. Disclosure Nothing to disclose.