Azygos continuation of the inferior vena cava
Incidental finding on CT of the chest performed when the patient was admitted to the ED for a motor vehicle accident.
CTA of the chest
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CTA demonstrates absence of the IVC with the liver draining directly into the right atrium. The azygos vein is very large, similar in caliber to the aorta and runs to the right of the later, to train via the azygos arch into the right atrium, enlarging the mediastinal outline. Note the regurgitation of contrast into the arch.
This is a typical example of azygos continuation of the IVC. As is the case in most patients, this seems to be an isolated abnormality.