Learning objectives
The objective of this educational poster is to highlight the various venous causes of abdominal pain
Acute abdomen is one of the commonest presentations at the emergency department.
In addition to the usual causes of abdominal pain,
a variety of vascular causes present as an acute abdomen
Rapid imaging and diagnosis is required to prevent morbidity and mortality.
Venous and arterial diseases need to be differentiated.
Background
The IVC is formed by the confluence of the left and right common iliac veins.
Numerous paired segmental lumbar veins drain into the IVC throughout its length.
The right gonadal vein enters directly into the IVC,
whereas thee left gonadal vein enters into the left renal vein.
The azygous system has connections with the IVC or the renal veins at the level of the renal veins.
The next major veins encountered are the renal veins,
followed by the hepatic veins.
No valves are within the...
Findings and procedure details
Renal vein Thrombosis
The renal vein may also contain thrombus after invasion by renal cell cancer.
Other less common causes include,
renal transplantation,
Behcet Syndrome,
Hypercoagulable states,
and antiphospholipid antibody syndrome
Hypercoagulability is the underlying process involved in both arterial and venous renal thrombosis.
Causes of renal vein thrombosis
1. Antithrombin III deficiency
2. Protein C or S deficiency
3. Antiphospholipid antibody syndrome
4. Pregnancy or estrogen therapy
5. Renal vein invasion by malignant cells
6. Post renal transplantation
7. Behçet syndrome
8. Extrinsic compression...
Conclusion
Modern fast CT scanners with multiphasic imaging protocols are excellent tool for diagnosis,
and can help in image guided intervention.
Porto-venous scans and delayed scans maybe helpful in certain cases.
Venous channels should always be evaluated on CT scans of the abdomen and pelvis,
as early diagnosis can reduce morbidity and mortality
Personal information
H Khosa
N El Saeity
N Ramesh
Consultant Radiologists,
Midland Regional Hospital,
Portlaoise,
Ireland
References
1.
Imaging of the Inferior Vena Cava with MDCT,
S Sheth,
EK Fishman: AJR,
2007: 189: 1243-1251
www.ajronline.org/doi/abs/10.2214/AJR.97.2133
2.
Abdominal Thrombotic and Ischaemic Manifestations of the Antiphospholipid Antibody Syndrome: S Kaushil et al:
DOI:http://dx.doi.org/10.1148/radiology.218.3.r01fe43768
3.
Mesenteric Venous Thrombosis: Diagnosis and non invasive Imaging Bradbury M S: DOI:http://dx.doi.org/10.1148/radiographics.22.3.g02ma10527