Supra Hepatic Inferior Vena Cava Thrombosis–Surgical Challenges
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts. There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of the retrohepatic Inferior Vena Cava (...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2016-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9108/23371_CE[Ra]_F(Sh)_PF1(PI_RK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a chronic affliction characterized by numerous liver and kidney cysts.
There is a gradual but progressive renal and liver impairment which may require combined liver-kidney transplantation. Compression of
the retrohepatic Inferior Vena Cava (IVC) by an enlarged polycystic liver may impede clear visualization on pre-operative imaging and
miss an underlying thrombosis or obliteration. This may result in an intra-operative surprise. Management can be challenging requiring
modification of conventional surgical approach. We present our experience of a 67-year-old patient who underwent combined liverkidney deceased donor transplantation for decompensated chronic liver disease with chronic kidney disease due to ADPKD. She was
diagnosed with ADPKD for 16 year, with progressive deterioration in kidney function over the last 6 year and liver decompensation
following knee replacement surgery requiring regular renal replacement therapy. We report this case to highlight the peri-operative
challenges and their management along with a review of published literature on this uncommon occurrence. |
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| ISSN: | 2249-782X 0973-709X |