Postrenal Segment Aneurysm and Infrahepatic Interruption of the Inferior Vena Cava

Abstract

Intrahepatic interruption of the inferior vena cava (IVC) with azygos and hemiazygos continuation is a well known anomaly. An aneurysm of the IVC has to our knowledge never been reported. A patient is described in whom a postrenal segmental aneurysm of the IVC in association with infrahepatic interruption was evaluated by cavography, ultrasound, and computed tomography. The different modes of evaluation are discussed with emphasis on the embryogenesis of the Iv'C.

Congenitally Interrupted Inferior Vena Cava without other Features of the Heterotaxy Syndrome: Report of Five Cases and Characterization of a Rare Entity

“…The enlarged AzV close to the aorta, especially a left-sided continuation, may be misinterpreted as the false lumen of a thoracic aortic dissection [43]. At the abdominal level, the dilated AzV or HemiAzV may resemble retroperitoneal and especially retrocrural lymphadenopathy [11,13] or metastasis [29].…”

Inferior Vena Cava Aneurysm

“…Many IVC aneurysms are discovered incidentally on imaging studies performed for unrelated reasons. 2,7,18,19 The most common presenting symptoms are vague abdominal pain 20,24 and leg swelling associated with lower extremity deep venous thrombosis with or without associated pulmonary embolism. 6,8,10,13,25 Other, more unusual presenting signs and symptoms include massive penile bleeding 5 and an enlarging epigastric mass.…”

“…Many cases were initially mistaken for neoplasms. 10,18 Thus, the diagnosis of IVC aneurysms should be considered in the differential diagnosis of retroperitoneal neoplasms. If the diagnosis is equivocal, a cavogram should be performed to delineate the venous anatomy.…”

“…18,24 Others were resected owing to thrombosis with associated lower extremity deep venous thrombosis with or without pulmonary embolism. 8,13 Some authors believe that IVC aneurysms should be resected to prevent the complications of deep venous thrombosis and pulmonary embolism.…”

Normal and Anomalous Structures Simulating Retroperitoneal Lymphadenopathy at Computed Tomography

“…Their tubular nature and absence of the inferior vena cava at the level of the liver should prevent confusion with abnormal lymph nodes. A case has recently been reported in which this anomaly was combined with a varix of the infrarenal inferior vena cava (16). Dilatation of the azygos and hemiazygos veins may also occur in other conditions with increased blood flow in this system, e.g.…”