An extremely rare complete bilateral duplication of inferior vena cava in a male cadaver: anatomy, embryology and clinical relevance

Abstract

The study presented an extremely rare case of real complete bilateral duplication of inferior vena cava (IVC) in a male cadaver which has never been reported before. Both IVC had approximately the same diameter. The right IVC drained into the right atrium; the left IVC continued as hemiazygos vein and drained into the superior vena cava. Three anastomotic venous channels, a cranial preaortic, a middle and a caudal retroaortic, joined both vessels. Multiple variations in the way of drainage of posterior intercostal veins, on both sides, were also present. The present report invalidates an old classification defining the two vessels when joined at the level of the renal veins as complete bilateral duplication of IVC. Although the presence of 2 combination of venous variations is extremely rare, awareness of such variations is essential for clinical and surgical procedures to avoid misdiagnosis and surgical complications.

The inferior vena cava: anatomical variants and acquired pathologies

“…4) [20]. Rarely, the duplicated segment can continue as the hemiazygos vein and drain directly into the superior vena cava [21,22]. Case reports of association with retrocaval ureters, horseshoe kidneys and malrotation of the gut have been described [23][24][25].…”

Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure

“…The duplicated IVC appears with an incidence of 0.2–3%. [ 2 , 8 ] A suggested classification is shown in Fig. 3 [ 9 ] Type 1 refers to normal IVC formation of the common iliac veins connection.…”

“…In the fourth week of embryogenesis, three venous systems are formed: the vitelline, the umbilical and the cardinal system. The IVC consists of four main segments: [ 2 , 5 ] the hepatic segment derives from the hepatic vein and the hepatic sinusoids; the prerenal segment originates from the right subcardinal vein; the renal segment is derived from the anastomosis of the right subcardinal anteriorly and supracardinal vein posteriorly; and the last one, the postrenal system, arises from the right supracardinal vein. Normally, the left subcardinal and supracardinal veins regress.…”

“…Its recognition is important intraoperatively, as it can prevent several complications such as hemorrhage, during interventional vascular practice, and prevent the misconception of the duplicated vessel as lymph nodes or masses. [ 2 , 10 ] Furthermore, this variation is related to about 5% of the deep vein thrombosis (DVT) and should be suspected in the recurrence of pulmonary thromboembolism. There is a debate concerning if the duplicated IVC is associated with an increased possibility of DVT [ 8 ].…”

Retroperitoneal lymphoma with double inferior vena cava shown using a 3D visualization model: A case report and literature review

“…The inferior vena cava (IVC) is the largest single vein in the human body, and is responsible for collecting venous blood from the abdomen, pelvic organs and lower extremities (1). Because of the complexity of its development during the embryonic stage, IVC can have a variety of anatomical variations in adulthood (2,3).…”