RESUMO
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.
Assuntos
Aorta/cirurgia , Artéria Ilíaca/cirurgia , Veias/anormalidades , Idoso , Humanos , Veia Ilíaca/anormalidades , Masculino , Veias Renais/anormalidades , Transposição dos Grandes Vasos/patologia , Veias Cavas/anormalidadesRESUMO
One hundred twenty-four patients, with 133 involved extremities having the clinical diagnosis of deep venous thrombosis of the lower extremity, were studied by phleborheography and phlebography. Seventy-two limbs were proved to have deep venous thrombosis and 61 to have no evidence of thrombi in the deep veins. Classic symptoms of muscle pain and muscle tenderness, swelling, and the presence of a positive Homans sign obtained by dorsiflexion of the foot were found to occur with approximately equal frequency in those limbs with and without deep venous thrombosis.
Assuntos
Perna (Membro)/irrigação sanguínea , Tromboflebite/diagnóstico , Diagnóstico Diferencial , Humanos , Métodos , Músculos , Dor , Flebografia , Estudos Prospectivos , Tromboflebite/diagnóstico por imagemRESUMO
There has been further experience with a new plethysmographic technique for diagnosing deep venous thrombosis of the lower extremity. Now called phleborheography, this technique is highly practical and noninvasive and can be conveniently performed in the laboratory, at the bedside or in the office of the physician by a technician. Interpretation of the permanent tracing may be learned by a physician in a short period of time. Since development of a new specifically designed instrument, the accuracy of the test is approximately 96 per cent when correlatewith phlebography.