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Azygos continuation of the inferior vena cava

Case contributed by Badis Al Harbawi
Diagnosis certain

Presentation

Acute abdominal pain

Patient Data

Age: 30 years
Gender: Female

The ovaries are slightly prominent in size, containing multiple follicles the largest one measures about 2.6 x 2.4 cm located in the right ovary. There is mild to moderate free fluid in the pelvis. Appearances are those of ruptured ovarian cyst.

The suprarenal and hepatic segment of the inferior vena cava (IVC) is absent with azygos continuation of the IVC. The azygos vein appears dilated and runs in its normal retrocrural course.

The hepatic veins drain into a short supradiaphragmatic IVC. The left renal vein drains into the hemiazygos vein which appears mildly dilated. No duplication of the IVC or left-sided IVC. Accessory spleen is seen near the splenic hilum, but no evidence of asplenia or polysplenia. 

The liver, spleen, pancreas, adrenals and both kidneys appear normal.

Case Discussion

This case represents an incidentally discovered, asymptomatic azygos continuation of the inferior vena cava with no evidence of heterotaxy or history of congenital heart disease.

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