Azygos and hemiazygos veins
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At the time the case was submitted for publication Chris O'Donnell had no recorded disclosures.View Chris O'Donnell's current disclosures
Assessment for aortic dissection. Bicuspid aortic valve and chest pain.
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Beautiful retrograde filling of azygos and hemiazygos veins via a right cubital fossa intravenous injection of radiographic contrast. Azygos vein rejoins the SVC in the chest and arises from the IVC posteriorly at the level of the right renal vein. The hemiazygos vein arises from a lumbar vein in the upper lumbar region and joins the azygos in the mid posterior mediastinum.
Azygos veins do not usually fill so dramatically on CT chest but in this case, the large volume of contrast used (150 mL) and high injection rate of 5 mL/s (in order to produce a dense aortogram) has led to contrast reflux into the azygos vein via the SVC.