A case of renal impairment and raised venous pressure

Johnston, D F; Drinkwater, S L; Backhouse, C I

doi:10.1259/bjr/68392357

Cited by 2 publications

(2 citation statements)

References 3 publications

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“…It already as been reported that IVC aneurysms are associated with longstanding venous hypertension in cases with outflow obstruction, 7 and venous hypertension can cause a decrease in the renal arterial perfusion pressure. 8 These statements are in accordance with the findings of IVC aneurysm associated with atretic suprarenal IVC (outflow obstruction) and absent blood flow in the right kidney (decrease perfusion) on Doppler study in our patient. We are aware of two reported cases of IVC aneurysm associated with renal insufficiency.…”

Section: Discussionsupporting

confidence: 93%

Combined Aneurysm and Infrahepatic Stenosis of the Inferior Vena Cava

Araújo¹,

Junqueira

2012

Journal of Diagnostic Medical Sonography

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A man in his late 60s was admitted to the hospital with a history of dyspnea, pain, and bilateral lower extremity swelling. The medical history was significant for chronic renal failure due to gout, treated with a long course of allopurinol. He had no history of a deep venous thrombosis (DVT). A sonogram without Doppler study, performed at another hospital, reported a large right renal cyst. On physical examination, the patient was 173 cm in height and weighed 89.9 kg, with blood pressure of 100/60 mm Hg. He was found to be anemic with hemoglobin of 7.8 g/dL and with raised blood urea nitrogen (50.0 mg/dL) and serum creatinine (2.51 mg/dL). Past medical records were not available. By transthoracic echocardiography, the estimated left ventricular ejection fraction was 29% with severe diastolic dysfunction. Ultrasonography, at our hospital, revealed echogenic kidneys with poor corticomedullary differentiation and small cortical cysts on both sides. Doppler study failed to demonstrate blood flow in the right kidney ( Figure 1A), whereas in the left kidney, the blood tree and spectral tracing were depicted ( Figure 1B). Incidentally, an anechoic outpouching was detected on the right wall of the inferior vena cava (IVC) at the level of the right renal vein (Figure 2A), showing a characteristic "swirling motion" within it on color Doppler interrogation ( Figure 2B). The IVC appeared to terminate at the level of the aneurysm. Although a tiny echogenic line had been seen AbstractAneurysms of the major veins are rare, and those involving the inferior vena cava (IVC) are extremely rare. The etiology of IVC aneurysms remains unknown, and they can have variable presentation. Although many aneurysms are found incidentally, others are diagnosed after complications develop. Thrombosis is a frequent presentation, and serious sequelae, such as lethal pulmonary embolism and Budd-Chiari syndrome, may result. Therapeutic alternatives range from watchful waiting to surgical management. Development of complications such as rupture has been described and may require surgery. In this article, we report the discovery of an IVC aneurysm in a patient who had chronic renal failure associated with renal hypoperfusion and severe cardiac insufficiency.

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Section: Discussionsupporting

confidence: 93%

Combined Aneurysm and Infrahepatic Stenosis of the Inferior Vena Cava

Araújo¹,

Junqueira

2012

Journal of Diagnostic Medical Sonography

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“…Acute renal insufficiency has been described in majority of patients presenting with this condition and is postulated to result from hypoperfusion resulting either from the shock state or severe venous hypertension [8]. The renal failure is potentially reversible, after closure of the shunt in most instances [9].…”

Section: Discussionmentioning

confidence: 99%

Aortocaval Fistula: A Rare Cause of Venous Hypertension and Acute Renal Failure

Takkar

Choi

Mastouri³

et al. 2012

Case Reports in Surgery

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Spontaneous rupture of abdominal aortic aneurysm into the inferior vena cava is rare and is associated with high mortality and morbidity. The clinical presentation can be variable and thus the diagnosis can be difficult. It can present with symptoms and signs of an abdominal emergency, venous hypertension, or systemic hypoperfusion. The traditional method of repair has been open surgery which is associated with high rate of complications. We report a case of aortocaval fistula (ACF) presenting with acute renal failure and heart failure, which was treated successfully with a novel, endovascular approach.

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A case of renal impairment and raised venous pressure

Cited by 2 publications

References 3 publications

Combined Aneurysm and Infrahepatic Stenosis of the Inferior Vena Cava

Combined Aneurysm and Infrahepatic Stenosis of the Inferior Vena Cava

Aortocaval Fistula: A Rare Cause of Venous Hypertension and Acute Renal Failure

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