Inferior vena cava (IVC) webs are an uncommon condition characterised by obstruction of the hepatic segment of the inferior vena cava by a membrane or fibrous band. This is often associated with occlusion of one or more of the hepatic veins.
If there is hepatic vein involvement, patients may present with Budd-Chiari syndrome.
It may be a congenital/developmental anomaly. More commonly they arise as fibrotic bands as post-thrombotic sequelae with the regressed thrombus replaced by a fibrous laminar structure. It can lead to hepatic outflow obstruction.
- intrahepatic IVC may have a linear filling defect representing the web
- features of hepatic vein obstruction may be present (also see: Budd-Chiari syndrome):
- flow reversal on Doppler ultrasound
- non-obstructed hepatic veins may be dilated
- collateral pathways between obstructed hepatic veins
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