title: The iatrogenic injury of double vena cava due to misdiagnosis during the radical nephroureterectomy and cystectomy.
abstract: Double inferior vena cava (d-IVC) is a subtype of vascular anomaly that rarely needs treatment. Here, we present a rare case of d-IVC accompanied with concurrent renal pelvis and bladder carcinoma. Due to misdiagnosis, the anomalous left inferior vena cava (IVC) entering the left renal vein was mistaken as the gonadal vein and was then severed during the radical nephroureterectomy. Fortunately, the injured left IVC was recognized correctly during the following cystectomy. The vascular reconstruction operation was performed to recanalize the left iliac veins by anastomosing the ligated vascular stump to the right IVC in an 'end-to-side' way. During the hospitalization, the patient was treated with 'low molecular weight heparin' and then warfarin to ensure an ideal international normalized ratio. He recovered well from the surgery. A meticulous and comprehensive analysis of radiographic imaging is critical to avoid misdiagnosis of d-IVC.
authors.affiliation: Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China. herrmau@163.com.
authors.forename: Ye-Qing
authors.initials: YQ
authors.lastname: Mao
authors.affiliation: Department of Urology, Zhejiang Cancer Hospital, 38 Guangji Road, Hangzhou, 31002, Zhejiang, People's Republic of China. zsxing2005@126.com.
authors.forename: Shao-Xing
authors.initials: SX
authors.lastname: Zhu
authors.affiliation: Department of Urology, Zhejiang Cancer Hospital, 38 Guangji Road, Hangzhou, 31002, Zhejiang, People's Republic of China. zhangwei@zjcc.org.cn.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
mesh_terms: D015653:Cystectomy; D003951:Diagnostic Errors; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D010386:Pelvic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D012082:Renal Veins / Q000601:surgery*; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D054079:Vascular Malformations / Q000473:pathology*; D014682:Vena Cava, Inferior / Q000293:injuries* / Q000473:pathology / Q000601:surgery