Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report
Patent paraumbilical and abdominal subcutaneous veins are found frequently as collaterals in patients due to portal hypertension mainly in liver cirrhosis.
For evaluation of portal hypertension in a 72-year-old Caucasian man without liver cirrhosis, magnetic resonance imaging with gadolinium contrast-enhancement was performed and demonstrated a missing inferior vena cava. A blood return from the lower extremities was shown through enlarged collateral veins of the abdominal wall, vena azygos and hemiazygos continuation, and multiple liver veins emptying into the right cardiac atrium. We describe a rare case of abdominal subcutaneous wall veins as collaterals caused by a congenitally absent infrarenal inferior vena cava with preservation of a hypoplastic suprarenal segment.
Knowledge of these congenital variations can be of clinical importance and it is imperative for the reporting radiologist to identify these anomalies as they can have a significant impact on the clinical management of the patient.
- Numminen K, Tervahartiala P, Halavaara J, Isoniemi H, Höckerstedt K: Non-invasive diagnosis of liver cirrhosis: magnetic resonance imaging presents special features. Scand J Gastroenterol 2005, 40:76–82. CrossRef
- Gupta D, Chawla YK, Dhiman RK, Suri S, Dilwari JB: Clinical significance of patent paraumbilical vein in patients with liver cirrhosis. Dig Dis Sci 2000, 45:1861–1864. CrossRef
- Evanchuk DM, Von Gehr A, Zehnder JL: Superficial venous thrombosis associated with congenital absence of the inferior vena cava and previous episode of deep vein thrombosis. Am J Hematol 2007, 83:250–52. CrossRef
- Iqbal J, Nagaraju E: Congenital absence of inferior vena cava and thrombosis: a case report. J Med Case Reports 2008, 2:46. CrossRef
- Kim MJ, Mitchell DG, Ito K: Portosystemic collaterals of the upper abdomen: review of anatomy and demonstration on MR imaging. Abdom Imaging 2000, 25:462–470. CrossRef
- Obernosterer A, Aschauer M, Schnedl W, Lipp RW: Anomalies of the inferior vena cava in patients with iliac vein thrombosis. Ann Intern Med 2002, 136:37–41.
- Schneider JG, Eynatten MV, Duex M, Nawroth PP: Recurrent deep vein thrombosis caused by congenital interruption of the inferior vena cava and heterozygous factor V Leiden mutation. J Intern Med 2002, 252:276–280. CrossRef
- 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, 20:639–652.
- Tiesenhausen K, Amann W, Thalhammer M, Aschauer M: Aplasia of the vena cava inferior as a cause for recurring thrombosis of the lower extremities and pelvic veins. Vasa 1999, 28:289–292. CrossRef
- Koc Z, Oguzkurt L: Interruption or congenital stenosis of the inferior vena cava: prevalence, imaging, and clinical findings. Europ J Radiol 2007, 62:257–266. CrossRef
- Thornton MJ, Ryan R, Varghese JC, Farrell MA, Farrell MA, Lucey B, Lee MJ: A three-dimensional Gadolinium-enhanced MR venography technique for imaging central veins. Am J Roentgenol 1999, 173:999–1003.
- Milner LB, Marchan R: Complete absence of the inferior vena cava presenting as paraspinous mass. Thorax 1980, 35:798–800. CrossRef
- Patent abdominal subcutaneous veins caused by congenital absence of the inferior vena cava: a case report
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of Medical Case Reports
- Online Date
- July 2010
- Online ISSN
- BioMed Central
- Additional Links
- Author Affiliations
- 1. Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, A-8036, Graz, Austria
- 2. Practice for General Internal Medicine, Hauptstrasse 5, A-8940, Liezen, Austria
- 3. Diagnostikum Sued-West, Weblinger Guertel 25, A-8054, Graz, Austria
- 4. Centre of Physiological Medicine, Institute of Physiological Chemistry, Harrachgasse 21/II, A-8010, Graz, Austria
- 5. Centre for Molecular Medicine, Institute of Pathophysiology, Heinrichstrasse 31a, A-8010, Graz, Austria