CC BY-NC-ND 4.0 · Journal of Morphological Sciences 2019; 36(04): 255-260
DOI: 10.1055/s-0039-1697009
Original Article
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Morphological and Histological Study of an ‘Iliac Venous Ladder’ Associated with Very Short Common Iliac Arteries

Satheesha B. Nayak
1   Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Sudarshan Surendran
1   Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Venu Madhav Nelluri
1   Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
,
Prakashchandra Shetty
1   Department of Anatomy, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, Karnataka, India
› Author Affiliations
Further Information

Publication History

05 September 2018

20 July 2019

Publication Date:
09 October 2019 (online)

Abstract

Introduction Communications between iliac veins in the pelvis are reported to be rare occurrences, which are mostly due to developmental abnormalities. The common iliac vein is formed by the joining of the internal and external iliac veins. Here, we present a detailed morphological and histological study of a rare communication found between the internal and external iliac veins, which would prove to be of substantial value to the knowledge of vessels in the pelvis, both for clinicians and surgeons.

Materials and Methods In the present study, we came across a rare communication in the form of a ladder, between the left internal and external iliac veins in a 70-year-old male cadaver. There were two communications (named upper and lower communications) between the external and internal iliac veins, before they joined to form the common iliac vein. On naked eye observation, the lumen of the right common iliac vein appeared to be wider than on the left side. The lengths of these communications and the distance between each of their attachments have been measured and tabulated. The walls of these veins, their microscopic sections and their communication involved in the case were taken. The possible causes for these variations were congenital, owing to the complicated nature of the developmental process involved in the formation of the inferior vena cava and the venous system of the lower limb.

Results The structure of all the veins involved in this case and the communications were seen to be normal. The thickness of these walls were measured and tabulated for uniformity around the circumference of the wall of these veins. All the measurements from the structural variations and from the histological observations are tabulated in our results.

Conclusion The complicated development sequence of these veins could have possibly led to the persistence of these communications. Such a developmental variation does not seem to pose any threat until unless encountered under clinical or surgical interventions, as the histological structure of the walls of the communications as well as the major channels connected appeared to be normal and well-developed. The detailed morphological and histological features of these structures involved in the variation along with the possible complications have been presented in the present report. Knowledge of these variations and complications due to injury plays a key role in a clinical setup.

 
  • References

  • 1 Bergman R, Thompson S, Afifi A, Saadeh F. Compendium of human anatomic variation. Urban and Schwarzenberg. Inc.; Baltimore, MD: 1988: 93
  • 2 Tanagho EA, McAninch JW, Smith M. General urology. McGraw-Hill,; New York: 2000
  • 3 LePage PA, Villavicencio JL, Gomez ER, Sheridan MN, Rich NM. The valvular anatomy of the iliac venous system and its clinical implications. J Vasc Surg 1991; 14 (05) 678-683
  • 4 Cardinot TM, Aragão AH, Babinski MA, Favorito LA. Rare variation in course and affluence of internal iliac vein due to its anatomical and surgical significance. Surg Radiol Anat 2006; 28 (04) 422-425
  • 5 Oto A, Akpinar E, Sürücü HS, Denk CC, Celik HH. Right internal iliac vein joining the left common iliac vein: case report demonstrated by CT angiography. Surg Radiol Anat 2003; 25 (3-4): 339-341
  • 6 Morita S, Saito N, Mitsuhashi N. Variations in internal iliac veins detected using multidetector computed tomography. Acta Radiol 2007; 48 (10) 1082-1085
  • 7 Standring S, Ellis HHJ, Johnson D, Williams A. Gray's anatomy: the anatomical basis of clinical practice. 40th ed. Elsevier: Churchill Livingstone; 2008
  • 8 Sürücü HS, Erbil KM, Tastan C, Yener N. Anomalous veins of the retroperitoneum: clinical considerations. Surg Radiol Anat 2001; 23 (06) 443-445
  • 9 Flynn MK, Romero AA, Amundsen CL, Weidner AC. Vascular anatomy of the presacral space: a fresh tissue cadaver dissection. Am J Obstet Gynecol 2005; 192 (05) 1501-1505
  • 10 Wieslander CK, Rahn DD, McIntire DD. , et al. Vascular anatomy of the presacral space in unembalmed female cadavers. Am J Obstet Gynecol 2006; 195 (06) 1736-1741
  • 11 Nygaard IE, McCreery R, Brubaker L. , et al; Pelvic Floor Disorders Network. Abdominal sacrocolpopexy: a comprehensive review. Obstet Gynecol 2004; 104 (04) 805-823
  • 12 Kurzel RB, Edinger Jr DD. Injury to the great vessels: a hazard of transabdominal endoscopy. South Med J 1983; 76 (05) 656-657
  • 13 Servelle M. Klippel and Trénaunay's syndrome. 768 operated cases. Ann Surg 1985; 201 (03) 365-373
  • 14 Stolic RV, Milojevic SP. Laceration of the iliac vein in a patient with a femoral catheter for hemodialysis. Int J Nephrol 2011; 2011: 919858
  • 15 Yadla M, Sainaresh V, Reddy S, Vijayalakshmi B, Lakshmi A, Sivakumar V. Malposition of hemodialysis catheter in left superior intercostal vein. Hemodial Int 2011; 15 (01) 115-116
  • 16 McGee DC, Gould MK. Preventing complications of central venous catheterization. N Engl J Med 2003; 348 (12) 1123-1133