An Anatomic and Roentgenographic Study of the Communications of the Renal Vein in Patients with and without Renal Carcinoma

Abstract

The communications of the renal vein with other venous regions were studied with a roentgen technique after the injection of a contrast medium into the renal vein in patients without carcinoma of the kidney (a) in vivo, and (b) at autopsy after distal ligation of the renal vein. Kidneys with and without carcinoma, excised perifascially, were examined roentgenographically after the injection of contrast material into the renal vein with a special technique. The communications of the renal vein were also studied with dissection at perifascial nephrectomy for renal tumour. The value of the different methods of examination is discussed briefly. At autopsy the veins in the fatty capsule were in every instance filled with contrast medium, as were communicants from these to adrenal veins and the lumbar plexus. The contralateral renal vein was contrast-filled in half of the cases. The right gonadal vein was observed in half the cases, and the left one in all of them. Communicants to veins of the liver capsule were demonstrable in half of the right-sided cases, and to the splenic veins in 70 per cent of the left-sided cases. Small veins from the fatty capsule to the inferior vena cava and to the lateral abdominal wall were observed in high frequency at dissection in the tumour cases. Roentgen examination of kidneys excised perifascially demonstrated substantially wider and more tortuous veins in the fatty capsule in the presence of renal carcinoma than when that condition was absent, especially when a tumour thrombus occluded the main trunk of the renal vein. The frequency figures in the present study are higher than in earlier investigations of the communications of the renal vein. The width of the communicating veins was significantly larger when renal carcinoma was present.