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Images of rare radiological findings.

Patient came to look for the service for evaluation of chronic pelvic pain and infertility without prior explanation, in the images of pelvic RM we observed a marked increase in the volume of the right ovary with accentuated vulval of its vascularization, so we chose to perform next to the examination a RM angiology of the Iliac arteries where we found a venous arteriovenous fistula originating from the right uterine artery with rapid venous drainage along the right renal vein.

Conclusion: complex arteriovenous fistula of the right ovary with rapid drainage to the renal vein.

#RMPELVIS #Arteriovenous fistula #Case of the week to close with a golden key

Radiobasilic arteriovenous fistula - Basilic vein transposition A 61-year-old male patient with a history of two previous radiocephalic and left brachiocephalic AVFs, with stenosis of the right brachiocephalic venous trunk due to the use of a temporary hemodialysis catheter. Aneurysmal left brachiocephalic AVF was closed and vein exeresis was performed. A third native AVF was created with the basilic vein of the forearm and the radial artery according to the image.

A 63 year old female patient with history of renal transplant and small indeterminate vascular malformation at the transplant renal hilum was referred for progressive weight loss, abdominal pain, and recurrent urinary tract infections. Multimodality evaluation revealed an enlarging and tortuous renal vein at the graft hilum demonstrating rapid filling on arterial phase followed by early inferior vena cava opacification. Findings were consistent with an enlarging arteriovenous fistula.

Possible complications of partial nephrectomies: perinephric hematoma, renal artery thrombosis, renal infarct, pseudoaneurysm, arteriovenous fistula, arteriocalyceal fistula, urinary fistula. In this patient a lower pole renal artery angiogram demonstrated a cut-off branch (white arrow), indicating an auto-thrombosed pseudoaneurysm. In addition the angiogram showed the presence of an arteriovenous fistula (blue arrow) and arteriocalyceal fistula (red arrow). Following coil embolization there was resolution of pseudoaneurysm, arteriovenous fistula and arteriocalyceal fistula.

This is an anatomical shot of the left renal vein. The gonadal vein and the adrenal vein are shown draining into the renal vein. This is unique to the left kidney wherein the gonadal vein and adrenal vein both drain into the renal vein. Why is this unique to the left kidney? How and why does drainage differ in the right kidney?