Figure 1
angio ct of the abdomen
The ct scan of the abdomen show tha anomalous position of the IVC
Clinical History
A 30 years old male with abdominal pain, was submitted to a body CT scan.
Imaging Findings
A 30 years old male presented in April 1989 with a vague abdominal pain. He referred an history of abdominal trauma (10 days before) due to a car accident. After a physical examination a contrast-enhanced CT was performed, which did not show any pathological finding but a venous vascular structure on both sides of the abdominal aorta.
Discussion
Duplication of inferior vena cava (IVC) is a rare variant of abdominal vessels and is normally located on both sides of abdominal aorta. The IVC is formed trough a complex process of embryogenesis from the sixth to the tenth week of gestation (II month); this is a complicated procedure involving development, regression, anastomosis and replacement of three pairs of venous channels (posterior cardinal, subcardinal and supracardinal). Improper completion of the process of embryogenesis may result in four anatomic anomalies: 1) duplication of IVC; 2) left-sided IVC; 3) retroaortic left renal vein and 4) circumaortic left renal vein.
These anomalies are most often asymptomatic but their understanding is essential for correct interpretation of the results of different immaging techniques and for effective performance of surgical and medical procedures concerning the IVC directly or indirectly.
In recent years, clinics and radiology of congenital anomalies of IVC have increased in importance in planning abdominal surgery, liver or kidney transplatation, or new interventional procedures such as the positioning of IVC filters to prevent pulmonary embolism, varicocele scleroterapy and venous renal sampling. In the past, radiologic assessment of this rare anomalies was performed only with angiography, which remains the most accurate diagnostic method. Today, besides angiography, less invasive examinations can be performed, i.e., US, CT, MRI.
In this case, contrast-enhanced CT allowed a clear definition of anatomy of this anomaly and enabled the correct diagnosis.
Differential Diagnosis List
Duplication of inferior vena cava (IVC)
Final Diagnosis
Duplication of inferior vena cava (IVC)
References
[1] Esposito S, Mansueto G, Amodio F, Meccariello R, Galasso L, Salzano A, Vallone G. Duplication of the vena cava inferior with a continuation into the vena azygos. A report of a rare case. Minerva Chir 1999 Apr;54(4):261-5. (PMID: 10380526)
[2] Rubinstein I, Cavalcanti AG, Canalini AF, Freitas MA, Accioly PM. Left retrocaval ureter associated with inferior vena cava duplication. J Urol 1999 Oct;162(4):1373-4. (PMID: 10492202)
[3] Cancrini A Jr, Bellotti C, Quagliarini L, Santoro A, Badiali M, Cancrini F, Delfini R. Anomalies of the inferior vena cava: observations on the anterior approach to the vertebral column. G Chir 1994 Apr;15(4):190-4. (PMID: 8086310)
[4] Urigo F, Carboni M, Conti M, Maiore M, Picciau M, Pischedda A, Salis A. The positioning of 2 caval filters in a case of duplication of the vena cava inferior. Radiol Med (Torino) 1994 Nov;88(5):701-5. (PMID: 7824799)
[5] Shingleton WB, Hutton M, Resnick MI. Duplication of inferior vena cava: its importance in retroperitoneal surgery. Urology 1994 Jan;43(1):113-5. (PMID: 8284871)
Case information
| URL: | https://www.eurorad.org/case/423 |
| DOI: | 10.1594/EURORAD/CASE.423 |
| ISSN: | 1563-4086 |
Figure 2
angio ct of the abdomen
In the superior scan is not possible to see any vascular veins near the aorta
Figure 3
angio ct of the abdomen
Superior scan. in this slice is possible to see the IVC
angio ct of the abdomen
The ct scan of the abdomen show tha anomalous position of the IVC
angio ct of the abdomen
In the superior scan is not possible to see any vascular veins near the aorta
angio ct of the abdomen
Superior scan. in this slice is possible to see the IVC