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Congenital and acquired abnormalities may alter the anatomy, size, or position of the azygos system. Computed tomography is often able to depict these abnormalities and in many cases indicate the cause. In this article, the normal anatomy of the azygos system is discussed and examples of congenital and acquired abnormalities are presented.

Fig. i -Anatomy.The roots enter the supraclavicular fossa by passing between the anterior and middle scalene muscles with the subclavian artery. These form three trunks near the lateral margin of the scalene muscles. The trunks travel superior and posterIor to the subclavian artery through the supraclavlcular fossa, separating into three antenor and three posterior divisions at the level of the clavicle. As the plexus crosses the first rib, the divisions form lateral, posterior, and medial cords. The terminal branches form at the lateral border of the pectoralIs minor muscle.

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