Evaluation of inferior mesenteric vein drainage patterns in the Turkish population: A multidetector computed tomography study

Inferior mesenteric vein drainage patterns

Authors

Keywords:

inferior mesenteric vein, computed tomography, variation

Abstract

Background/Aim: The inferior mesenteric vein (IMV) plays a crucial role in the venous system as it joins the superior mesenteric vein (SMV) and splenic vein to form the portal vein. The widespread adoption of multidetector computed tomography (MDCT) has greatly enhanced our ability to assess abdominal vascular structures. This study aimed to investigate the IMV drainage patterns in a Turkish population using MDCT.

Methods: This descriptive, single-center, retrospective study included patients who had undergone abdominal computed tomography (CT) in the portal phase at our hospital for various clinical indications. Excluded from the study were patients who did not undergo imaging in the portal venous phase, those with incomplete evaluation of all IMV segments, and individuals who had undergone pancreaticoduodenal or intestinal surgery for any reason. We retrospectively analyzed a total of 877 contrast-enhanced MDCT examinations performed at our hospital between March 2022 and March 2023. Patients were classified based on their IMV drainage patterns into the following categories: type 1 (drainage into the splenic vein), type 2 (drainage into the SMV), type 3 (drainage at the junction level), type 4 (drainage into the branches of the SMV), and type 5 (patients in whom IMV assessment was not possible).

Results: The mean age of the patients was 48.7 years (range: 24–92 years), with 449 (51.2%) being male and 428 (48.8%) female. The distribution of patients according to IMV drainage patterns was as follows: type 1, n=379 (43.2%); type 2, n=398 (45.4%); type 3, n=71 (8.1%); type 4, n=15 (1.7%); and type 5, n=14 (1.6%).

Conclusion: Our study findings indicate that in the Turkish population, the IMV predominantly drains into the SMV before joining the splenic vein. This disparity from certain studies in the literature underscores the variability in IMV drainage patterns, emphasizing the importance of individualized patient evaluation in this regard.

Downloads

Download data is not yet available.

References

Horton KM, Fishman EK. Volume-rendered 3D CT of the mesenteric vasculature: normal anatomy, anatomic variants, and pathologic conditions. Radiographics. 2002;22(1):161-72. doi: 10.1148/radiographics.22.1.g02ja30161 DOI: https://doi.org/10.1148/radiographics.22.1.g02ja30161

Nepal P, Mori S, Kita Y, Tanabe K, Baba K, Sasaki K, et al. Anatomical study of the inferior mesenteric vein using three-dimensional computed tomography angiography in laparoscopy-assisted surgery for left-sided colorectal cancer. Surg Today. 2021;51(10):1665-70. doi: 10.1007/s00595-021-02292-8 DOI: https://doi.org/10.1007/s00595-021-02292-8

Kaur R, Sharma A, Sharma MK, Singh R, Sharma A. Variations in drainage pattern of inferior Mesentric vein. Int J Anat Res. 2017;5(4.2):4581-4. DOI: https://doi.org/10.16965/ijar.2017.401

Sakaguchi T, Suzuki S, Morita Y, Oishi K, Suzuki A, Fukumoto K, et al. Analysis of anatomic variants of mesenteric veins by 3-dimensional portography using multidetector-row computed tomography. Am J Surg. 2010;200(1):15-22. doi: 10.1016/j.amjsurg.2009.05.017 DOI: https://doi.org/10.1016/j.amjsurg.2009.05.017

Krumm P, Schraml C, Bretschneider C, Seeger A, Klumpp B, Kramer U, et al. Depiction of variants of the portal confluence venous system using multidetector row CT: analysis of 916 cases. Rofo. 2011;183(12):1123-9. doi: 10.1055/s-0031-1281745 DOI: https://doi.org/10.1055/s-0031-1281745

Graf O, Boland GW, Kaufman JA, Warshaw AL, Fernandez del Castillo C, Mueller PR. Anatomic variants of mesenteric veins: depiction with helical CT venography. AJR Am J Roentgenol. 1997;168(5):1209-13. doi: 10.2214/ajr.168.5.9129413 DOI: https://doi.org/10.2214/ajr.168.5.9129413

Arimoto A, Matsuda T, Hasegawa H, Yamashita K, Nakamura T, Sumi Y, et al. Evaluation of the venous drainage pattern of the splenic flexure by preoperative three-dimensional computed tomography. Asian J Endosc Surg. 2019;12(4):412-6. doi: 10.1111/ases.12657 DOI: https://doi.org/10.1111/ases.12657

Akpinar E, Turkbey B, Karcaaltincaba M, Karaosmanoglu D, Akata D. MDCT of inferior mesenteric vein: normal anatomy and pathology. Clin Radiol. 2008;63(7):819-23. doi: 10.1016/j.crad.2007.09.001 DOI: https://doi.org/10.1016/j.crad.2007.09.001

Taydas O, Kantarci M, Bayraktutan U, Ogul H. Supradiaphragmatic origin of the renal artery; frequency on contrast-enhanced MR imaging. Clin Imaging. 2018;52:152-6. doi: 10.1016/j.clinimag.2018.07.018 DOI: https://doi.org/10.1016/j.clinimag.2018.07.018

Iannaccone R, Laghi A, Passariello R. Multislice CT angiography of mesenteric vessels. Abdom Imaging. 2004;29(2):146-52. doi: 10.1007/s00261-003-0096-9 DOI: https://doi.org/10.1007/s00261-003-0096-9

Yılmaz BK, Diker M, Aslan S, Atasoy B, Karahasanoglu R, Gocgun N, et al. Evaluation of left renal vein and IVC variations in MDCT examinations performed in patients with a preliminary diagnosis of renal calculi. J Surg Med. 2023;7(1):128-32. doi: 10.28982/josam.7681 DOI: https://doi.org/10.28982/josam.7681

West NP, Kobayashi H, Takahashi K, Perrakis A, Weber K, Hohenberger W, et al. Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol. 2012;30(15):1763-9. doi: 10.1200/jco.2011.38.3992 DOI: https://doi.org/10.1200/JCO.2011.38.3992

Siani LM, Lucchi A, Berti P, Garulli G. Laparoscopic complete mesocolic excision with central vascular ligation in 600 right total mesocolectomies: Safety, prognostic factors and oncologic outcome. Am J Surg. 2017;214(2):222-7. doi: 10.1016/j.amjsurg.2016.10.005 DOI: https://doi.org/10.1016/j.amjsurg.2016.10.005

Bertelsen CA, Neuenschwander AU, Jansen JE, Kirkegaard-Klitbo A, Tenma JR, Wilhelmsen M, et al. Short-term outcomes after complete mesocolic excision compared with ‘conventional’ colonic cancer surgery. Br J Surg. 2016;103(5):581-9. doi: 10.1002/bjs.10083 DOI: https://doi.org/10.1002/bjs.10083

Negoi I, Beuran M, Hostiuc S, Negoi RI, Inoue Y. Surgical Anatomy of the Superior Mesenteric Vessels Related to Colon and Pancreatic Surgery: A Systematic Review and Meta-Analysis. Sci Rep. 2018;8(1):4184. doi: 10.1038/s41598-018-22641-x. DOI: https://doi.org/10.1038/s41598-018-22641-x

Downloads

Published

2023-10-06

Issue

Section

Research Article

How to Cite

1.
Yilmaz H. Evaluation of inferior mesenteric vein drainage patterns in the Turkish population: A multidetector computed tomography study: Inferior mesenteric vein drainage patterns. J Surg Med [Internet]. 2023 Oct. 6 [cited 2024 May 25];7(10):656-9. Available from: https://jsurgmed.com/article/view/7980