Radiological evidence of anatomical variation of the inferior vena cava: Report of two cases

Abstract

The inferior vena cava (IVC) is a retroperitoneal key structure whose location and integrity must be checked in every scan. A number of studies are reported in the literature concerning congenital variations of the inferior vena cava. Anatomical variations of this main venous trunk are relatively infrequent clinical findings during surgery or diagnostic procedures in patients without symptoms such as an aberrant venous drainage or abdominal pain. Among the other imaging techniques, computerized tomography is a non-invasive, effective technique for diagnosing diseases of the retroperitoneal space and, particularly, for detecting anomalies of the main vessels, such as the aorta or IVC, in asymptomatic patients. We present two cases of IVC variation as an incidental finding in patients studied by means of CT scan for the gradation of kidney carcinoma and pancreatic cancer respectively. Two different configurations of the system of the IVC (agenesis of the IVC with hypertrophy of the azygos vein and a double IVC respectively) were found in our cases. The embryological development of the IVC system is discussed, bearing in mind that knowledge of the different variations is important in order to avoid major surgical complications.

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

“…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.…”

“…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].…”

Double inferior vena cava with three shunts: a rare anomaly with important implications for surgeons

“…In addition, we have found 5 more DIVC cases in the same period of 2000-2011, which have not been included in the review of Ang et al [1]. Artico et al [3] detected a case of DIVC in an adult male patient during a computed tomography (CT)--scanning for follow-up of pancreatic cancer. Kumar [10] reported a case of an adult male cadaver having the DIVC, which ascended to join the left renal vein before connecting to the right IVC.…”

“…Anatomical variation of the IVC occurs in 0.4-4% of the population [14]. Among the abnormalities related to the formation of the IVC, the double IVC (DIVC) was the most common anatomic variation [3]. We report here a case of DIVC with three short venous shunts and a variant pattern of the hemiazygos vein in a Thai cadaver.…”

Double Inferior Vena Cava Detected by CT Venography and Confirmed by Magnetic Resonance Venography: Embryogenesis and Literature Review

“…During the fifth to the eighth week of embryonic period, the IVC develops as a composite structure via chronological events of formation, regression, anastomosis and substitution of three symmetrical sequential pairs of veins, the posterior cardinal, subcardinal and supracardinal (Artico et al, 2004). The right IVC typically reassembled through four caudocranial embryologic segments: subrenal, renal, suprarenal and hepatic.…”