Learning objectives
Anomalies of the inferior vena cava (IVC) have long been underappreciated.
The development of imaging techniques has contributed the most in the diagnosis of these conditions.
Being uncommon they were reported rarely in the past – during dissections,
surgery or later as a cause of failed attempts for cardiac catheterization.
Our aim is to bring to the radiologists’ attention one of the rarest venous anomalies – absence of inferior vena cava.
To provide some basic information about the IVC embryology and other venous anomalies.
To...
Background
DEVELOPMENT OF THE INFERIOR VENA CAVA
Basic knowledge of the IVC embryogenesis is essential to understand the related anomalies.
The embryologic period encompasses a series of transformations in several venous networks.
Connections between precursor veins form the four different parts of the definitive IVC – hepatic,
suprarenal,
renal and infrarenal.
The mesonephros becomes well vascularized during gestational week 4.
By that time it is drained by the parallel posterior cardinal veins.
After week 4 the drainage of the mesonephros is done by the recently developed...
Findings and procedure details
CLINICAL ISSUES
Most of the times the AIVC is asymptomatic and is diagnosed incidentally by imaging.
The most common clinical symptoms are related to venous insufficiency of lower extremities and/or idiopathic deep venous thrombosis.
A recent report states that 5% of the patients with idiopathic deep venous thrombosis who are under 30 years old have an absent IVC.
An increase of the renal venous pressure could lead to haematuria.
Varicocele in men or pelvic congestion syndrome in women could be other causes for clinical symptoms....
Conclusion
Absence of the inferior vena cava is one of the rarest anomalies of the venous system.
It is so uncommon that when not clinically manifested it could be a challenge for the radiologist.
It should be considered in patients,
especially young people,
presenting with venous flow abnormalities.
CECT or MRI are essential for the diagnosis,
being able to not only show the absence of the IVC but also assess the related abnormalities – usually collateral pathways and deep venous thrombosis (DVT).
Venography is a very...
References
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