Anomalías congénitas de la vena cava inferior. El rol de la ...

1 0 4 AbrilJunio 2012

Dr. Alberto Emilio Morató López*Dr. Óscar Quiróz Castro**Dr. José Luis Ramírez Arias*

Anomalías congénitas de la vena cava inferior. El rol de la tomografía computada multidetector

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RESUMEN

Introducción. Las anoma/1&4"9+*0E*.(&4",$"/&"8$*&"9&8&".*;$'.+'" VW?2X" 4+*" '$4R/(&,+",$" /&" %$'4.4($*9.&" +" '$0'$4.M*"anormal de una de las venas $)L'.+*&'.&4"%'$9R'4+'&4@"7+*"'&'&4" <" 0$*$'&/)$*($" 4+*" U&//&O0+4".*9.,$*(&/$4"QR$"%R$,$*"(&)L.E*"%&4&'",$4&%$'9.L.,+4@"N&"(+)+0'&;1&"9+)%R(&,&")R/(.,$($9(+'"V:?H#X"$4"$/")E(+,+",$"$/$99.M*"%&'&"4R",.&0*M4(.9+@Objetivos."-$8.4&'"/&4"9&'&9

($'14(.9&4"&*&(M).9&4"<"$)L'.+/M0.9&4F"&41"9+)+"/&4".)%/.9&9.+*$4"9/1*.9&4"<"QR.'Y'0.9&4",$"/&4"&*+)&/1&4",$"/&"W?2"<",$)+4('&'"/&"R(./.,&,",$"/&":?H#"%&'&"4R"$8&/R&9.M*@Tipos de anomalía de la VCI.

N+4" %'.*9.%&/$4" 4+*P" &X" 8$*&"'$*&/" .OQR.$',&" '$('+&M'(.9&F" LX"

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iscusión. =/" ,.&0*M4(.9+"

,$"&*+)&/1&",$"/&"W?2"%$').($"&/")E,.9+"(+)&'"/&4"9+*4.,$'&ciones pertinentes de acuerdo 9+*"$/" (.%+" V)+,.\9&9.+*$4" $*"(E9*.9&4" QR.'Y'0.9&4F" $4(R,.+4"9+)%/$)$*(&'.+4F" %'$8$*9.M*",$" ('+)L+4.4" 8$*+4&F" $(9@X@"

N&":?H#",$)R$4('&" &,$9R&,&)$*($" $4(&4" &*+)&/1&4" &41"9+)+"U&//&O0+4"&4+9.&,+4"9+)+"8Z'.9$4" ,$" &]R$*($4" <[+" ('+)L+4.4@Conclusión."N&4"&*+)&/1&4"

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Palabras clave:" &*+)&/1&"9+*0E*.(&F" 8$*&" 9&8&" .*;$'.+'F"( +) + 0 ' & ; 1 & " 9 +)% R ( & , &")R/(.,$($9(+'F"('+)L+4.4"8$*+4&@

Continúa en la pág. 105

ARTÍCULO DE REVISIÓN!"#$%&'(%')#(*+$+,-#'./0*1+'23425264378449:

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$*"%'+9$,.).$*(+4",$"9&($($'.4)+"9&',1&9+F"9+/+9&9.M*",$"\/('+4",$"/&"W?2FGFa"%/&*$&9.M*",$"9.'R01&"9&',1&9&"<"'$%'$4$*(&*"R*"'.$40+"%+($*9.&/",$"9+)%/.9&9.M*",R'&*($"&9(+4"QR.'Y'0.9+4",$/"&L,+)$*F"%'.*9.%&/)$*($"$*"'$('+%$'.(+*$+"<"$*"%'+9$,.).$*(+4".*($'8$*9.+*.4(&4@BFb

Introducción=I.4($"R*"&)%/.+"$4%$9('+",$"&*+)&/1&4"9+*0E*.(&4"

,$" /&"8$*&"9&8&" .*;$'.+'" VW?2XBFc con una prevalencia 0$*$'&/" $4(.)&,&"$*('$" C@^>C@Dd"$*('$" /&" %+L/&9.M*"4&*&"<",$"U&4(&"cd"$*"%&9.$*($4"9+*"+('&4"&*+)&/1&4"9&',.+8&49R/&'$4@^Fe"=4(&4"&*+)&/1&4"4+*"9+*4.,$'&,&4"$*(.,&,$4"'&'&4`"4.*"$)L&'0+F"9+*"$/"&,8$*.).$*(+",$"/&"*R$8&"($9*+/+01&",$"(+)+0'&;1&"9+)%R(&,&")R/(.,$($9(+'"V:?H#X"<"&,QR.4.9.M*",$"$4(R,.+4"9+*")$,.+",$"

1 0 5AbrilJunio 2012

Viene de la pág. 104

ABSTRACT

Introduction." ?+*0$*.(&/"&*+)&/.$4"+;"(U$".*;$'.+'"8$*&"9&8&" V2W?X" &'$" (U$" '$4R/(" +;"persistence or abnormal re0'$44.+*"+;"+*$"+;"(U$"$)L'<+*.9"%'$9R'4+'" 8$.*4@":U$<"&'$"'&'$"&*,"R4R&//<"&'$".*9.,$*(&/"\*,.*04"(U&(")&<"0+"R**+(.9$,@"HR/(.,$($9(+'"9+)%R($,"(+)+0'&%U<"VH#?:X".4"(U$")$(U+,"+;"9U+.9$";+'",.&0*+4.4@Objectives. " -$8.$f" (U$"

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Classification. :U$" )+4("9+))+* " 2W? " 9+*0$* . ( & /"&*+)&/.$4" &'$P " &X" '$('+&+'(.9"/$;(" '$*&/" 8$.*F" LX" 9.'9R)&+'(.9"/$; ( " '$*&/ " 8$.*F " 9X " ,+RL/$".*;'&'$*&/"2W?F",X"/$;(".*;'&'$*&/"2W?F"$X"9+*(.*R&(.+*"+;"2W?"f.(U"&O<0+4" +'" U$).&O<0+4" 8$.*F"&*,";X"&L4$*9$"+;"2W?@"=&9U"+;"(U$4$" &*+)&/.$4" U&4" ,.;;$'$*("g.*,4" +;" 9/.*.9&/" &*," 4R'0.9&/".)%/.9&(.+*4F" fU.9U" .*9/R,$"0'$&($'" '.4g" +;" ,$$%" 8$*+R4"(U'+)L+4.4" &*,[+'" 9U'+*.9"8$*+R4" .*4R;;.9.$*9<" &*," (U$"%+($*(.&/" '.4g" +;" 9+)%/.9&(.+*4".*"&L,+).*&/"+'"9U$4("4R'0$'.$4"&*," )&<" 9&R4$" ,.&0*+4(.9"$''+'4".*".)&0$"($4(4@Discussion. #.&0*+4.4"

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Key words: " 9+*0$*. (& /"&*+)&/<F" .*;$'.+'" 8$*&" 9&8&F"mu l t i d e t e c t o r c ompu t ed (+)+0'&%U<F"8$*+R4"(U'+)L+4.4@

K/0R*&4",$"$4(&4"&*+)&/1&4")+4('&'+*" 4$'" ;&9(+'",$"'.$40+"%&'&",$4&''+//&'"('+)L+4.4"8$*+4&"%'+;R*,&F"%'.*9.%&/)$*($" $*" /&4" 8$*&4" ./1&9&4" <" $*" %&9.$*($4"hM8$*$4@^FBC Las series publicadas indican prevalencias ,$"('+)L+4.4",$"U&4(&"$/"b@Dd@3"J.*&/)$*($F"%R$,$*"4$'")+(.8+",$"9+*;R4.M*"$*"$4(R,.+4",$".)&0$*@BFBBFBc"N&":?H#" 9+*")$,.+" ,$" 9+*('&4($" .*('&8&49R/&'"

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Material y métodos7$" '$&/.OM" R*" $4(R,.+" R*.9E*('.9+F" ,$49'.%(.8+F" '$

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Vena vitelinaderecha

V. subcardinal

V. supracardinal

Ácigos Hemiácigos

V. cardinal posterior

Segmentos de la VCI

Intrahepático

Suprarrenal

Renal

Infrarrenal

Aorta

Conductos de Couvier Vena umbilical derecha Vena vitelina derecha

Bulbo arterial

Ventrículo primitivo

Aurícula primitiva

Senos venosos

Figura 1."7$0)$*(+4",$"/&"8$*&"9&8&".*;$'.+'

Figura 2."=/" (RL+"9&',1&9+@"N+4"9+*,R9(+4",$"?+R8.$'",$'$9U+4" ;+')&*" %&'($" ,$/" 4.4($)&"Z9.0+4@"=/" 4$*+" 8$*+4+".OQR.$',+"4$"U.%+('+\&"%&'&"9+*8$'(.'4$"$*"$/"4$*+"9+'+*&'.+@


V. subcardinal



V. subcardinal


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Figura 6."K('+\&",$"/&4"8$*&4"9&',.*&/$4"%+4($'.+'$4"9+*"$I('$)+4")Z4"9&R,&/$4@"=/"]Rh+"8$*+4+"4$",.'.0$"U&9.&"/&4"8$*&4"4R%'&9&',.*&/$4"<"4RL9&',.*&/$4"&"('&8E4",$"/&4"&*&4(+)+4.4@

Figura 7."K('+\&",$"/&4"8$*&4".OQR.$',&4@"=/"]Rh+",$"4&*0'$"8$*+4&"$4"%'$;$'$*9.&/"&"('&8E4",$"/&4"8$*&4",$'$9U&4@

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V. subcardinal

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ReferenciasB@" n&*,%&/"3F"7U&')&"-F"q&)&*0&((."7F"

7'.8&4(&8&"#AF"W&4U.4U("7@"2)&0.*":U$"2*;$'.+'"W$*&"?&8&P"K"-+&,"N$44":'&8$/$,`"-&,.+0'&%U.94"cCCa`caP__br_ab@

c@" s&44" t=F" -$,f.*$"H#F" n'&)$'" NKF"3R<*U"6:F"3&''.4"t3@"7%$9('R)"+;"9+*0$*.(&/" &*+)&/.$4"+;" (U$" .*;$'.+'" 8$*&"9&8&P"9'+44>4$9(.+*&/".)&0.*0"\*,.*04@"-&,.+0'&%U.94"cCCC`cCP_^b>_Dc@

^@" JR/9U$'"K7F":R'*$'"HK@"KL,+).*&/")&*.;$4(&(.+*4"+;"4.(R4"&*+)&/.$4".*"&,R/(4@"-&,.+0'&%U.94"cCCc`ccPBe^b>BeD_@

e@" q&<$'"qF"NRL+4U.(O"tF"3$'(O"HF"o.44.*"-F":U&/$'"HF"NRL$(4g<"KF"$("&/@"?+*0$*.(&/"K*+)&/.$4"+;"(U$"2*;$'.+'"W$*&"?&8&"-$8$&/$,"+*"?:".*"6&(.$*(4"f.(U"#$$%"W$.*":U'+)L+4.4`"Kt-"cCC^`BaCPGcbrG^c@

D@" 7U$(U" 7F" s'&*4($(($'" sJF" =49+((" =t@"2)&0.*0"+;"(U$"2*;$'.+'"W$*&"?&8&"f.(U"H#?:̀ "Kt-"cCCG`BabPBce^rBcDB@

_@" n+9"oF"j/R4&*"7F"m0ROgR'("NF":+g)&g"A@"W$*+R4"8&'.&*(4"&*,"&*+)&/.$4"+*"routine abdominal multidetector row ?:@"=R'"t"-&,.+/"cCCG`_BPc_G>cGa@

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Anomalías congénitas de la vena cava inferior. El rol de la ...

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