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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

A Journal on Internal Medicine and Pharmacology


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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2014 April;173(4):233-6

language: English

Rupture of abdominal aortic aneurysm in a patient with transposition of the inferior vena cava

Figueiredo Braga S. 1, 2, Ferreira J. 1, Canedo A. 1, Brandão P. 1, Guedes Vaz A. 1

1 Department of Angiology and Vascular Surgery, Centro Hospitalar de Vila Nova de Gaia / Espinho, Vila Nova de Gaia, Portugal;
2 Department of Anatomy, Porto Medical School University of Porto, Porto, Portugal


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Congenital anomalies of the retroperitoneal venous system, particularly those involving the inferior vena cava and left renal vein, although uncommon and usually incidental findings on imaging or at operation, can be troublesome and dangerous during open repair of abdominal aortic aneurysms (AAA). The purpose of this paper is to describe a case of surgical treatment of a ruptured AAA associated with transposition of IVC. A 68-year-old male patient, admitted to the Nephrology Department, developed sudden abdominal and back pain. Computed tomographic angiography demonstrated contained abdominal aortic aneurysm rupture and left-sided IVC, ventrally crossing the aneurysm’s neck, supposed difficult clamping and anastomosing. Graft replacement was performed, with careful mobilization and retraction of the inferior vena cava. The patient had an uneventful postoperative course. The case demonstrates the importance of pre-operative imaging for successful treatment of ruptured AAA in the presence of a challenging venous anomaly.

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