Aneurysms of the azygos vein

Kreibich, Maximilian; Siepe, Matthias; Grohmann, Jochen; Pache, Gregor; Beyersdorf, Friedhelm

doi:10.1016/j.jvsv.2016.12.012

Cited by 20 publications

(35 citation statements)

References 39 publications

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“…Azygos vein aneurysm is extremely rare with less than 60 cases reported worldwide 1 . And it can be mistakenly diagnosed as paratracheal tumour, 2 bronchial cyst, 3 calcified lymph node 4 and even metastatic lymph node in our case.…”

Section: Figurementioning

confidence: 67%

Missed diagnosis of azygos vein aneurysm mimicking mediastinal lymph node

Deng

Tang

2020

ANZ Journal of Surgery

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Section: Figurementioning

confidence: 67%

Missed diagnosis of azygos vein aneurysm mimicking mediastinal lymph node

Deng

Tang

2020

ANZ Journal of Surgery

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“…We report a case of AVA with mycological implantation of A. fumigatus as visualized by fiber bronchoscopy. AVAs are uncommon and occasionally diagnosed by accident; they can be mistaken for a mediastinal mass or tumor arising from the accessory pleura [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…It is often described as a saccular, fusiform, or oval mass that varies between 2.5 and 5 cm in diameter. It has been hypothesized that AVAs have a congenital origin given that in most published cases the aneurysm was located at a critical point of anatomical weakness, which corresponds to the union between two embryological vessels: the right supracardinal vein (azygos vein) and the right anterior cardinal vein (superior vena cava) [ 2 , 3 ].…”

Section: Introductionmentioning

confidence: 99%

Azygos Vein Aneurysm with Thrombosis and Aspergillus fumigatus Diagnosed Using Bronchoscopy: Case Report

Claudett

Briones-Claudett²,

Moreno³

et al. 2020

Am J Case Rep

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Patient: Female, 86-year-old Final Diagnosis: Aspergillus fumigatus infection • azygos vein aneurysm with thrombosis Symptoms: Acute respiratory failure • paresthesia Medication: — Clinical Procedure: Bronchoscopy Specialty: Critical Care Medicine • General and Internal Medicine • Pulmonology Objective: Unusual clinical course Background: The venous system of the posterior thoracic wall merges into a single trunk called the azygos vein, located in the posterior mediastinum, before draining into the superior vena cava. An aneurysm in the azygos vein is extremely rare. Such aneurysms are discovered as incidental radiology findings or while investigating a mediastinal mass. Visualization via bronchoscopy is atypical. Case Report: An 86-year-old female patient presented to the Emergency Department with a 5-day complaint of dyspnea and chest pain. She was admitted because of worsening condition leading to respiratory failure and paresthesias. She underwent endotracheal intubation and invasive mechanical ventilatory support. A chest X-ray showed a thickened mediastinum, tortuous thoracic aorta, and bilateral perihilar infiltrate with right predominance. Bronchoscopy revealed bleeding along the right bronchus and a blue protrusion coated with white material at the entrance of the main right bronchus. A pulmonary computed tomography angiography confirmed the presence of an azygos vein dilatation. Culture of bronchoalveolar lavage revealed Aspergillus fumigatus . Conclusions: Bronchoscopy as a diagnostic method allows clinicians to verify the state and permeability of the airways during investigation of azygos vein aneurysms, which are rare entities but should be considered in the differential diagnosis of mediastinal masses and may be complicated by fungal pathogens such as Aspergillus fumigatus mostly in immunocompromised patients.

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“…Radiographically, the normal sized azygos vein (AV) is typically ≤1 cm however caliber can vary between anatomic regions and volume status. Although there is no formal, diagnostic size criteria for AVA, focal dilation of ≥2.5 cm at the AV body and ≥ 3.75 cm at the AV arch have been purposed [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Multifactorial dysphagia: Azygos vein aneurysm (AVA) and esophagogastric junction outflow obstruction (EGJOO)

Morton

Grubic

Ayazi

et al. 2021

International Journal of Surgery Case Reports

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Introduction Vascular impingement of the esophagus is a rare cause of dysphagia, and is most commonly due to aortic arch anomalies such as arterial lusoria. Dysphagia resultant from venous compression is even further less likely. Presentation of case We present a highly unusual case of dysphagia secondary to a large aneurysm of the azygous vein near its confluence with the superior vena cava, which was managed with endovascular modalities. Despite initial treatment success, patient reported some intermittent solid food dysphagia, and was also found to have esophagogastric junction outflow obstruction (EGJOO) on high resolution impedance manometry (HRIM) which was successfully managed with surgical myotomy and partial fundoplication. Discussion The azygos vein has an intimate anatomic relationship with the esophagus as it traverses the posterior mediastinum. Because of this anatomic association, the azygos vein may present a point of esophageal obstruction in the setting of significant pathology. Conclusion This case highlights the possibility of multifactorial causes of dysphagia, and that HRIM is a key aspect of this workup. Additionally we discuss the pertinent anatomy, diagnosis, and treatments for azygos vein aneurysm and EGJOO.

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Aneurysms of the azygos vein

Cited by 20 publications

References 39 publications

Missed diagnosis of azygos vein aneurysm mimicking mediastinal lymph node

Missed diagnosis of azygos vein aneurysm mimicking mediastinal lymph node

Azygos Vein Aneurysm with Thrombosis and Aspergillus fumigatus Diagnosed Using Bronchoscopy: Case Report

Multifactorial dysphagia: Azygos vein aneurysm (AVA) and esophagogastric junction outflow obstruction (EGJOO)

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