Radiologic anatomy of duplication of the inferior vena cava: A trap in abdominal imaging. A report of 8 cases

Abstract

Eight cases of duplication of the inferior vena cava are reported. Three of these bear witness to the errors of interpretation that may be committed when the anomaly is not initially detected in the ultrasonographic transverse sections and when no preliminary phlebography is available. Two other cases illustrate the influence of this duplication on the choice of the prophylactic surgical treatment of pulmonary embolism. The last clinical observation indicates the need to puncture both the femoral veins when performing iliocaval phlebography. Finally, two observations on the cadaver help to clarify the imaging appearances of this anomaly. The report concludes with a review of the classical anatomic and pathogenic concepts and a short discussion of the practical problems posed by duplication of the inferior vena cava.

Duplication of the inferior vena cava: anatomy, embryology and classification proposal

“…Type I or major duplication, as in our case, comprises two bilaterally symmetrical and approximately of the same caliber trunks and a preaortic trunk of the same calider. In this type, the left and the right IVCs are just near the lateral border of the aorta (Senecail et al 1987;Wagner and Bogush 1993). Type II or minor type comprises two bilaterally symmetrical and approximately of the same caliber trunks, but is smaller in comparison to the preaortic trunk.…”

“…Therefore, we defined our case as complete bilateral duplication of the IVC because it comprised both the renal and the infrarenal segment of the IVC. We further classified the complete bilateral duplication according to the review of the literature (Waterston 1913;Rischbieth 1914;Senecail et al 1987;Lewis 1992;Wagner and Bogush 1993;Itoh et al 2001;Sórócó et al 2001;Tohno et al 2006;Xue et al 2006) into three types (Fig. 3).…”

“…Among the anatomic studies (Senecail et al 1987;Khaledpour et al 1990;Itoh et al 2001;Sórócó et al 2001;Xue et al 2006) that fully describe this anatomic variation, there is a basic difference at the drainage point of the rudimentary left IVC to the right IVC. The way these two vessels anastomose designates the type of duplication, and this has not been discussed in detail previously.…”

Advanced gastric carcinoma combined with extra-adrenal pheochromocytoma resected after three courses of S-1 and cisplatin as neoadjuvant chemotherapy: Report of a case

“…Based on necropsy materials the incidence is estimated to be around 2%-3%. 14,15 This patient had an advanced gastric carcinoma combined with an extra-adrenal pheochromocytoma which was mistaken for a para-aortic metastatic lymph node.…”

Approach to the educational opportunities provided by variant anatomy, illustrated by discussion of a duplicated inferior vena cava

“…For the demonstration of detailed anatomy, including accessory conduits for thromboemboli, bilateral injection of contrast has been recommended (Putnam et al, 1999;Reinus and Gutierrez, 1986;Soltes et al, 1992). Inferior vena cava duplication is not a component of any commonly recognized syndromes, although some authors favor screening for associated renal anomalies when diagnosed (Senecail et al, 1987).…”