Congenital anomalies of the inferior vena cava. Review of embryogenesis and presentation of a simplified classification

Chuang, V P; Mena, C E; Hoskins, Phillip A.

doi:10.1259/0007-1285-47-556-206

Cited by 319 publications

(175 citation statements)

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“…In the abdomen, the post-cardinal veins are progressively replaced by the subcardinal and supracardinal veins but persist in the pelvis as the common iliac veins. The aberrant development of these venous systems, for unknown reasons, causes anomalies of the IVC system [7].…”

Section: Discussionmentioning

confidence: 99%

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Variant ventral intrahepatic course of inferior vena cava: volume-rendering and maximum intensity projection CT findings

Abdullah

Williamson²,

Lewis³

et al. 2011

BJR

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ABSTRACT. Anatomically, the inferior vena cava (IVC) courses through the liver posteriorly and drains into the right atrium. We describe an extremely rare case of the anterior intrahepatic course of the IVC that drained into the right atrium seen on a CT scan of a healthy 26-year-old female who presented to the emergency room with abdominal pain. The anterior intrahepatic segment was bridged to the posteroinferior portion of the IVC by an oblique segment. Associated renal and arterial anomalies were also observed in our patient. Since the development of cross-sectional imaging, congenital anomalies of the inferior vena cava (IVC) and its tributaries have been encountered more frequently in asymptomatic patients [1,2]. Vascular structures are usually readily identified on CT scans of the abdomen and pelvis obtained with intravenously administered contrast material.Multiple congenital anomalies of IVC have been described in the literature including left-sided IVC, double IVC, azygos continuation of the IVC, circumaortic left renal vein and retroaortic left renal vein [3,4]. Other anomalies include the absence of the infrarenal IVC or the entire IVC. Some variations are associated with congenital heart disease, but detection of unusual IVC system in patients without any clinical symptoms by CT is not uncommon [5].We describe an extremely rare case of an anteriorly located variant intrahepatic course of the IVC with an oblique segment bridging this anterior intrahepatic segment with the posterior inferior segment of the IVC. In reporting this case, we have used maximum intensity projection (MIP) imaging to depict the structural relationship of IVC to adjacent viscera. Case reportA 26-year-old female presented to the emergency room with a 3 day history of generalised abdominal pain and vomiting. Medical and surgical histories were unremarkable. The patient had no known history of IVC dissection or iatrogenic IVC injuries. Laboratory values were within normal limits. A contrast-enhanced CT scan was performed to exclude bowel pathology.Incidentally, CT imaging showed an intrahepatic portion of the IVC coursing anteriorly through the liver and the diaphragm with anatomical insertion into the right atrium (Figure 1a). This anterior intrahepatic segment was bridged to the posteroinferior portion of the IVC by an oblique segment (Figure 1d). The inferior phrenic veins were not well visualised. The hepatic veins were seen traversing anteriorly to insert into the ventrally located intrahepatic IVC (Figure 1c). The renal veins were seen coursing anteriorly to drain into the oblique segment (Figure 1b). Normal morphology was observed within the portal venous system. The infrarenal IVC demonstrated a normal retroperitoneal course and calibre without any associated anomalies. The ovarian veins demonstrated a normal drainage pattern with the left ovarian vein draining into the left renal vein and the right ovarian vein draining into the infrarenal IVC. The lumbar veins were not enlarged and demonstrated a normal course. The commo...

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Section: Discussionmentioning

confidence: 99%

“…Anomalies of the IVC occur in less than 1% of patients and can be readily recognised on multidetector row CT and MR angiography [7]. With advances in non-invasive vascular imaging, anatomical variants and anomalies of the IVC have become more commonly recognised in routine practice.…”

Section: Discussionmentioning

confidence: 99%

Variant ventral intrahepatic course of inferior vena cava: volume-rendering and maximum intensity projection CT findings

Abdullah

Williamson²,

Lewis³

et al. 2011

BJR

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“…[1][2][3] This anomaly is classified into several types, and according to the classification proposed by Takemoto, et al, the present case belonged to Type II-b-4.…”

Section: Discussionmentioning

confidence: 97%

A Case of Deep Venous Thrombosis With a Double Inferior Vena Cava Effectively Treated by Suprarenal Filter Implantation

et al. 2004

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SUMMARYEmbryogenesis of the inferior vena cava (IVC) is a complex process involving the formation and regression of several anastomoses, thus, various anomalies may occur. We report a case of deep venous thrombosis (DVT) accompanied by a double inferior vena cava (DIVC). A 76-year-old-man was admitted because of right leg edema and pain. Venography revealed two IVC and massive venous thrombus. To avoid massive pulmonary embolism (PE), it was necessary to block both the right and the left IVC. However, the right IVC was too small to implant the filter, so we placed a temporary IVC filter (Antheor filter) in the suprarenal portion of the IVC, after the confluence of the two IVC, and started thrombolytic and anticoagulant therapy. Venography, performed 6 days after filter implantation, showed a considerable amount of remaining thrombus. We replaced the Antheor filter with a Günther retrievable filter because the former has a catheter and is not suited for long-term use, whereas the latter can be used permanently. Two weeks after filter exchange, thrombus had decreased but remained. We therefore did not remove the Günther filter. The patient's symptoms gradually improved in response to anticoagulant therapy, and he was discharged with no complications. The present case illustrates the importance of a correct understanding of anatomy and demonstrates the effectiveness of using a suprarenal IVC filter in DVT. (Jpn Heart J 2004; 45: 1063-1069 Key words: Double inferior vena cava, Deep venous thrombosis, Inferior vena cava filter A double inferior vena cava (DIVC) is a congenital anomaly that commonly results from persistence of the embryonal venous system and occurs in 2% to 3% of the population.1-3) We encountered a case of DIVC accompanied by deep venous thrombosis (DVT), which sometimes brings about fatal pulmonary embolism (PE). A DIVC is rarely associated with DVT. However, the position of the From the

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“…9 Accordingly, various anomalies can develop in the IVC and the left renal vein, including transposition of the IVC (incidence 0.2-0.5% 1,5 ), duplication of the IVC (incidence 2.2-3.0% 1,2 ), circumaortic renal collar (incidence 2.4-8.9% [1][2][3][4] ) and retroaortic renal veins (incidence 1.8-3.3% 1-4 ). 10,11 These various anomalies have Fig.…”

Section: Discussionmentioning

confidence: 99%

Possible misinterpretation on computed tomography of left inferior vena cava as retroperitoneal lymph node metastasis: A report of two cases

et al. 1999

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Purpose: We report on two cases of retroperitoneal lymph node metastasis of testicular cancer with left inferior vena cava. Methods/Results: A 25-year-old man with a left testicular cancer with pulmonary and retroperitoneal lymph node metastases received three courses of VIP (etoposide, ifosfamide and cisplatinum) chemotherapy. Subsequent abdominal computed tomography (CT) revealed round lesions enhanced with contrast agent on both sides of the aorta inside the degenerated lymphadenopathy. These lesions were regarded as a duplicated inferior vena cava (IVC) and this was confirmed at retroperitoneal lymph node dissection. The second case is of a 21-year-old man with a left testicular cancer with pulmonary, liver and widespread lymph node metastases. Subsequent to a course of VIP chemotherapy, super high-dose chemotherapy was administered. Abdominal CT revealed a round mass enhanced with contrast agent on the left side of the aorta adjacent to the degenerated lymphadenopathy, which was regarded as the transposed left IVC and this was confirmed at lymph node dissection. Conclusions:In both cases, initial CT failed to detect the lesions as the left IVC and there was a possibility for the misinterpretation of such venous anomalies with residual lymphadenopathy.

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Congenital anomalies of the inferior vena cava. Review of embryogenesis and presentation of a simplified classification

Cited by 319 publications

References 10 publications

Variant ventral intrahepatic course of inferior vena cava: volume-rendering and maximum intensity projection CT findings

Variant ventral intrahepatic course of inferior vena cava: volume-rendering and maximum intensity projection CT findings

A Case of Deep Venous Thrombosis With a Double Inferior Vena Cava Effectively Treated by Suprarenal Filter Implantation

Possible misinterpretation on computed tomography of left inferior vena cava as retroperitoneal lymph node metastasis: A report of two cases

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