Enlarged azygos vein
Dr Jeremy Jones and Dr Yuranga Weerakkody et al.
An enlarged/dilated azygos vein may result from a number of physiological as well as pathological causes. The enlarged azygos vein may be seen as a widened right para spinal stripe on a frontal chest film.
Causes for dilatation
There are a number of physiological causes for enlargement of the azygos vein such as pregnancy and over hydration, but most cases are pathological:
- azygous continuation of the inferior vena cava (IVC)
- aorto-azygous fistula 1
- congestive heart failure (CHF)
- constrictive pericarditis
- congenital SVC interruption (distal to azygous entry)
- SVC obstruction (distal to azygous entry 3)
- congential IVC interruption
- IVC obstruction
- pericardial effusion
- portal hypertension
- right ventricular strain
- tricuspid insufficiency
Differential diagnosis
The differential diagnosis depends on the radiographic study being reviewed; on a CXR, the differential includes:
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