Enlarged azygos vein from portal hypertension

Case contributed by Sipan Mathevosian


68 year old female with chronic, persistent chest, right arm pain, and shortness of breath.

Patient Data

Age: 68
Gender: Female

Wide mediastinum due to prominent azygos node in the right tracheobronchial groove

Enlarged azygos coursing superiorly along the right anterior vertebral body before draining into the SVC. Also visible is a cirrhotic liver and enlarged hemiazygos vein.

Case Discussion

The azygos vein courses on the right paravertebral aspect posterior to the IVC and drains the posterior thorax, until it courses over the right tracheobronchial groove and empties into the posterior SVC; it is an important connection between the SVC and IVC. In patients with cirrhosis and portal hypertension, variceal dilation results in portosystemic collaterals, which may include a rare spontaneous portoazygos shunt with resultant dilation 1.

This case was submitted with supervision and input from:

Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center

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Case information

rID: 47224
Published: 7th Aug 2016
Last edited: 25th Sep 2019
System: Vascular
Inclusion in quiz mode: Excluded

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