Absence of the Right Common Iliac Vein with the Right Internal Iliac Vein Arising from the Left Common Iliac Vein: Case Report

Abstract

The common iliac vein arises from the internal and external iliac veins and drains into the inferior vena cava, bilaterally. Historically, many anatomical variants of the common iliac vein have been studied. To our knowledge, we discuss a unique specimen, which presents with an absent right common iliac vein and a right internal iliac vein draining into the contralateral common iliac vein. It is important that we understand the anatomic variations of the pelvic venous system to prevent iatrogenic injury to patients or misdiagnosis.

Absence of right common iliac vein causing suprapubic and scrotal varices in a young athletic man

“…Although previous studies have described the congenital absence of common iliac veins and their branches, the anatomy of this patient is unique in several ways 2,3 . He had a patent right external and internal iliac vein.…”

“…Any malformation of the cardinal veins may lead to agenesis of the common iliac veins 2 . Specifically, anomalies of the iliac confluence of the posterior cardinal vein can result in the congenital absence of the right common iliac vein, as seen in this case 2,3 .…”

“…In patients without a CVO and congenital venous malformations, such as seen in this case, surgical intervention remains the most pressing life-threatening risk 2,3,4,8 . Magnetic resonance imaging modalities, such as MRV, are radiation-free and highly valuable to appreciate the patient's anatomy and rule out DVT and abdominopelvic masses 3 .…”

“…Although arterial and venous malformations are possible, congenital venous malformations account for two-thirds of worldwide cases. Specifically, the congenital absence of the right common iliac vein is a distinctly rare clinical entity, with only a few isolated instances documented in the literature, most of which are discovered during cadaveric dissection 2,3 . Thrombosis or congenital anomalies of the common iliac vein may present as suprapubic varicosities and hence should prompt further clinical investigation.…”

Pelvic Lymphadenectomy in Gynecologic Oncology—Significance of Anatomical Variations

“…Surgical considerations. All types of CIV variations are related to possible venous injuries ( Figure 13 ) [ 35 , 69 , 70 , 71 , 72 , 73 , 74 ]. Iatrogenic damage could occur during dissection of all five types of common iliac lymph node groups.…”