左下大静脈の1例

Abstract

This report deals with a case of left inferior vena cava. A discussion was made on embryological growth of inferior vena cava and on relation between asymptomatic hematuria and left inferior vena cava. A 19-year-old boy was admitted with asymptomatic hematuria. Since 4 years ago, he has noticed asymptomatic hematuria occasionally and been treated as essential renal bleeding on the left side at the other hospital. He had no remarkable physiological signs on chest and abdomen. Neither abnormal dilatation of the vein nor varicocele was found. All hematological tests were within normal limits and coagulation examinations showed almost normal but for bleeding time which was slightly prolonged. Hepatic and renal functions were unimpaired. Cystoscopic examination revealed that the urine ejected from the left ureteral orifice was slightly bloody, but that from the right side was clear. The bladder mucosa appeared normal. Excretory urogram and retrograde pyelogram showed no abnormality. Abdominal aortogram and selective renal angiogram revealed no abnormality but inferior vena cavogram showed the left sided inferior vena cava. Radioisotopic venogram was taken in order to find the physiological blood stream of the vena cava, and then vena cava was compressed clearly at the crossing area of the abdominal aorta. It was suggested that hematuria resulted from the congestion of left renal vein caused by the compression of the left inferior vena cava due to crossing the abdominal aorta.