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Answer to Photo Quiz: Traffic jam and collateral pathways



PHOTO QUIZ
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DIAGNOSIS

Congenital stenosis of the IVC. This is characterized by narrowing of the IVC, with or without a web formation, mostly at the diaphragmatic level or hepatic segment.1,2 The reported prevalence rate of interrupted IVC with azygos or hemiazygos continuation is 0.6%.1,3 If a well-developed azygos or hemiazygos continuation is present, the patient will most likely be asymptomatic.
If it is absent, this type of anomaly would be expected to be symptomatic. Presence of acute or recurrent deep vein thrombosis, diffuse varices, varicocele, hemorrhoids venous aneurysm, or venous collaterals (including the abdominal wall) in a relatively young patient can indicate interruption or congenital stenosis of the IVC. Noninvasive imaging modalities such as multidetector row computed tomography (MDCT) and magnetic resonance imaging (MRI) are the most reliable methods for identification of these anomalies.3


REFERENCES

  1. Minniti S, Visentini S, Procacci C. Congenintal anomalies of the vena cavae embryological origine, imaging features and report of three new varients. Eur Radiol. 2002;12:2040-55.
  2. Okuda K. Membranous obstruction of the inferior vena cava (obliterative hepatocavopathy, Okuda). J Gastroenterol Hepatol. 2001;16:1179-83.
  3. Bass JE, Redwine MD, Kramer LA, Huynh PT, Harris JH. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 2000;20:639-52. 



DISCLOSURES

All authors declare no conflicts of interest. No funding or financial support was received.