The left adrenal central vein, ovarian vein, and lumbar vein
were ligated and transected to release the LRV [Figure 1]i.
The patient underwent emergency laparotomy during which bleeding from the lumbar vein
was detected and repaired.
Spontaneous Retroperitoneal Hematoma from Lumbar Vein
. Retroperitoneal hematoma is a rare clinical condition, with an incidence of 0.1%, and as high as 0.6% in patients receiving oral anticoagulation therapy.
It was later demonstrated in the distal IVC by transfemoral venography, which also showed ascending lumbar vein
collaterals draining into the proximal IVC.
Contrast abdominopelvic CT showed an old complete thrombosis of the left common iliac vein, recent complete thromboses of the left venous junctions (external and internal iliac veins, common femoral deep and superficial veins, ascending lumbar vein
and various presacral collaterals), dilated azygos vein, partial eccentric thrombosis of the IVC, approximately 18 mm lower than the flow level of the right renal vein, with a 5mm clot on a length of 27mm, with a reduced caliber on almost its entire length from the origin to the level of the caudate lobe.
It is located anteriorly to the spine and runs almost transversely to the side, crossing anteriorly the pillars of the diaphragm and the muscles psoas major and minor; being also situated anteriorly to the lumbar sympathetic chain and the ascending lumbar vein
; and posteriorly to the head of the pancreas, descending part of duodenum, inferior vena cava and right renal vein.
aberrations, including agenesis and collaterals have also been associated with vena cava anomalies.
Caudally, they join the corresponding subcardinal vein close to the inter-cardinal anastomosis thus the azygos vein originates as the ascending lumbar vein
on both sides.
(3) A right subcostal vein joining the ascending lumbar vein
formed in 70% of cases.30% of cases it is formed from back of Inferior Vena Cava.
We are reporting two cases in which a lumbar vein
had an unusual course and termination on the left side and in one of these cases, was accompanied by a lumbar artery.