부산대학교 도서관

Introduction: Agenesis of IVC (inferior vena cava) is a rare congenital anomaly which is generally incidentally found in asymptomatic patients. In patients with congenital intra-abdominal venous malformation, extreme care must be taken during radiological or surgical interventions. Case Report: A 35-year-old male patient was presented with nausea and vomiting following abdominal CT- performed for chronic abdominal pain-, presenting a subsequent decrease in urine output, and elevation of blood urea and creatinine. The patient had suffered from disseminated varicosities since the age of 15. In physical examination, intense subcutaneous venous collaterals on both lower extremities and abdomen and hepatosplenomegaly were observed. Grade 2 hydronephrosis in the right kidney and grade 4 hydronephrosis with decreased parenchymal thickness in the left kidney were present on renal ultrasonography. CT scan revealed discontinuity of contrast in the left portal vein compatible with portal vein thrombosis. On the left, ureteral continuity was not found. MR venography revealed an abnormally narrow IVC. The diagnosis was established as contrast induced nephropathy and the patient underwent hemodialysis. After 3 sessions, serum urea and creatinine levels, renal functions, and urine excretion returned to normal. The patient was discharged and a follow-up was planned. Discussion: Recognition of vascular abnormalities is important to prevent related complications. Agenesis of IVC enhances the risk of acute renal failure; regarding decreased renal fi ltration due to insuffi ciency of venous return and the mass effect on ureters, Extreme caution or even total abstinence for contrast media injection is necessary. Surgeons and interventional radiologists should be warned against potential complications.