Presentation
Acute abdominal pain
Patient Data
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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