Complication arising from a duplicated inferior vena cava following laparoscopic living donor nephrectomy: a case report.
Selecting a kidney for living donor nephrectomy is driven by the tenet that donors are left with the higher functioning kidney. Traditionally, the left kidney is used because it has a longer renal vein, which aids anastamosis, and has an easier surgical approach. Anomalous left renal vasculature is not considered a contraindication to living donor nephrectomy. In the case of duplicated inferior vena cava, no specific considerations have been reported. We present a 42-year-old patient with infrarenal duplication of the vena cava who underwent laparoscopic living donor nephrectomy. His postoperative course was complicated by painful scrotal swelling necessitating multiple emergency room visits. Ultrasonography revealed bilateral hydroceles 5 weeks after surgery, which resolved with the use of a scrotal sling. Intraoperative ligation of a visibly dilated left gonadal vein was the likely etiology. Careful consideration should be taken in living donor nephrectomy in patients with duplication of inferior vena cava.
Yale School of Medicine, New Haven, Connecticut 06511, USA. Panos.Christakis@yale.edu
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Christakis
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Kulkarni
D000328:Adult; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy / Q000009:adverse effects*; D019520:Living Donors; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects*; D010690:Phlebography / Q000379:methods; D006848:Testicular Hydrocele / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014463:Ultrasonography; D014682:Vena Cava, Inferior / Q000002:abnormalities* / Q000000981:diagnostic imaging