Presentation
Left flank pain
Patient Data
Non-enhanced computed tomography (CT) of the abdomen showing an absent infrarenal inferior vena cava. The left renal colic (left ureteral calculus with associated ureterohydronephrosis and peri-ureteral/renal fat stranding) was causing the patient's symptoms.
Absent infrarenal inferior vena cava, infra-pubic subcutaneous varices, calcified adrenal glands, and hypodense liver lesion of the segment VI (+ steatosis) were all incidental findings.
Further incidental finding of mild increased attenuation of central small bowel mesentery with well defined edge, and containing non-enlarged lymph nodes with a fat halo around them, indicating mesenteric panniculitis.
Case Discussion
Absence of the infrarenal inferior vena cava (IVC) is a rare finding that can be congenital or due to perinatal IVC thrombosis. In this situation, the iliac veins will drain into enlarged lumbar veins toward prominent azygos and hemiazygos veins. The renal veins will join to form the suprarenal IVC.