Dextrocardia and azygous continuation of the interrupted inferior vena cava
35 years old primigravida for 28-weeks scan. 18 weeks scan showed dextrocardia.
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The heart is located in the right hemithorax with the heart axis directed to the right and caudad with
atrioventricular and ventriculoarterial concordance.
Atrial septal defect, septum secundum type is present.
Aorta and pulmonary arteries are on the right side of the trachea.
The thoracic and abdominal aorta is seen on the right side.
IVC is absent and dilated azygous vein is in the left side depicted azygos continuation of the inferior vena cava.
The post-hepatic segment of the IVC (derived from the right vitelline vein) is present, draining only
the hepatic veins into the right atrium.
The liver and gall bladder are in the midline position.
spleen and stomach are on the left side.
The rest of the fetal anatomical survey was normal.
The interesting points of the recent case are the combination of the dextrocardia and transposition of great abdominal arteries including the aorta and azygous vessels.
Double vessel sign in the axial views of the thoracic and abdominal fetus sonography is supporting the diagnosis of the azygos continuation of the inferior vena cava.