PMC6580713_01
(A) Axial CT scan showing compressed LRV at decreased aortomesenteric angle.
(B) Sagittal CT scan showing the reduction of the aortomesenteric angle and
compressed LRV. (C) Coronal CT scan showing dilatation of the left gonadal
vein. LRV indicates left renal vein.
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The scanning parameters were slice thickness of 0.5 mm for 64 slices; pitch factor of 0.828 (helical pitch 53); rotation time of 0.4 s, and standard exposure modulation based on attenuation values of the two scout views (antero-posterior and latero-lateral) which showed decreased aortomesenteric distance and compression of LRV by SMA (Figure 1).
Selective LRV venogram showing sever LRV compression between the abdominal
aorta and superior mesenteric artery. LRV indicates left renal vein.
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A selective venography of the LRV through femoral vein access revealed significant external compression of the LRV, markedly dilated pre-compression LRV and huge venous collaterals (Figure 2).
Intra-operative images: (A) Shows the A. aortomesenteric angle, B. LRV and C.
the IVC. (B) Shows the adrenal vein. (C) Shows the partial clamp of the IVC
and the anastomosis between the LRV and the IVC after transposition. (D)
Shows the new site of the LRV on the IVC. IVC indicates inferior vena cava;
LRV, Left Renal Vein.
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The adrenal veins were scarified and the ovarian vein was preserved (Figure 3).