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Azygos Continuation of Inferior Vena Cava
Jonathan Hero Chung, MD; Prabhakar Rajiah, MBBS, MD, FRCR, FSCMR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Azygos continuation of inferior vena cava (IVC)
            • Synonyms

              • Interruption of IVC
              • Absence of hepatic segment of IVC with azygos continuation
            • Definitions

              • Absence of suprarenal/intrahepatic IVC
                • Hepatic veins drain directly into right atrium
              • Large azygos vein carries venous return from lower extremities
                • Large hemiazygos vein in left-sided IVC

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Kim SS et al: Various congenital anomalies of the inferior vena cava: review of cross-sectional imaging findings and report of a new variant. Abdom Radiol (NY). 43(8):2130-49, 2018
                                        2. Ghandour A et al: Congenital anomalies of the superior vena cava: embryological correlation, imaging perspectives, and clinical relevance. Can Assoc Radiol J. 68(4):456-62, 2017
                                        3. Ghandour A et al: Congenital anomalies of the IVC-embryological perspective and clinical relevance. Cardiovasc Diagn Ther. 6(6):482-92, 2016
                                        4. Smillie RP et al: Imaging evaluation of the inferior vena cava. Radiographics. 35(2):578-92, 2015
                                        5. Yildirim A et al: An unusual case of heterotaxy and polysplenia syndrome associated with hemiazygous continuation of the left-sided vena cava inferior, dilated azygous vein and large venous ectasia. Congenit Heart Dis. 6(3):262-5, 2011
                                        6. Mamidipally S et al: Azygous continuation of inferior vena cava. J Am Coll Cardiol. 56(21):e41, 2010
                                        7. Morita S et al: Pelvic venous variations in patients with congenital inferior vena cava anomalies: classification with computed tomography. Acta Radiol. 48(9):974-9, 2007
                                        8. Bartram U et al: Heterotaxy syndrome -- asplenia and polysplenia as indicators of visceral malposition and complex congenital heart disease. Biol Neonate. 88(4):278-90, 2005
                                        9. Demos TC et al: Venous anomalies of the thorax. AJR Am J Roentgenol. 182(5):1139-50, 2004
                                        10. Plata-Muñoz JJ et al: Polysplenia syndrome in the adult patient. Case report with review of the literature. Ann Hepatol. 3(3):114-7, 2004
                                        11. Yilmaz E et al: Interruption of the inferior vena cava with azygos/hemiazygos continuation accompanied by distinct renal vein anomalies: MRA and CT assessment. Abdom Imaging. 28(3):392-4, 2003
                                        12. Bass JE et al: Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 20(3):639-52, 2000
                                        13. Applegate KE et al: Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 19(4):837-52; discussion 853-4, 1999
                                        14. Gayer G et al: Polysplenia syndrome detected in adulthood: report of eight cases and review of the literature. Abdom Imaging. 24(2):178-84, 1999
                                        15. Jelinek JS et al: MRI of polysplenia syndrome. Magn Reson Imaging. 7(6):681-6, 1989
                                        16. Munechika H et al: Hemiazygos continuation of a left inferior vena cava: CT appearance. J Comput Assist Tomogr. 12(2):328-30, 1988
                                        17. Cohen MI et al: Accessory hemiazygos continuation of left inferior vena cava: CT demonstration. J Comput Assist Tomogr. 8(4):777-9, 1984
                                        18. Schultz CL et al: Azygos continuation of the inferior vena cava: demonstration by NMR imaging. J Comput Assist Tomogr. 8(4):774-6, 1984
                                        19. Siegfried MS et al: Diagnosis of inferior vena cava anomalies by computerized tomography. Comput Radiol. 7(2):119-23, 1983
                                        20. Allen HA et al: Case report. Left-sided inferior vena cava with hemiazygos continuation. J Comput Assist Tomogr. 5(6):917-20, 1981
                                        21. Ginaldi S et al: Absence of hepatic segment of the inferior vena cava with azygous continuation. J Comput Assist Tomogr. 4(1):112-4, 1980
                                        22. O'Reilly RJ et al: The lateral chest film as an unreliable indicator of azygos continuation of the inferior vena cava. Circulation. 53(5):891-5, 1976
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Clinical Issues

                                                • Diagnostic Checklist

                                                  TERMINOLOGY

                                                  • Abbreviations

                                                    • Azygos continuation of inferior vena cava (IVC)
                                                  • Synonyms

                                                    • Interruption of IVC
                                                    • Absence of hepatic segment of IVC with azygos continuation
                                                  • Definitions

                                                    • Absence of suprarenal/intrahepatic IVC
                                                      • Hepatic veins drain directly into right atrium
                                                    • Large azygos vein carries venous return from lower extremities
                                                      • Large hemiazygos vein in left-sided IVC

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  CLINICAL ISSUES

                                                                  • Presentation

                                                                    • Demographics

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Kim SS et al: Various congenital anomalies of the inferior vena cava: review of cross-sectional imaging findings and report of a new variant. Abdom Radiol (NY). 43(8):2130-49, 2018
                                                                              2. Ghandour A et al: Congenital anomalies of the superior vena cava: embryological correlation, imaging perspectives, and clinical relevance. Can Assoc Radiol J. 68(4):456-62, 2017
                                                                              3. Ghandour A et al: Congenital anomalies of the IVC-embryological perspective and clinical relevance. Cardiovasc Diagn Ther. 6(6):482-92, 2016
                                                                              4. Smillie RP et al: Imaging evaluation of the inferior vena cava. Radiographics. 35(2):578-92, 2015
                                                                              5. Yildirim A et al: An unusual case of heterotaxy and polysplenia syndrome associated with hemiazygous continuation of the left-sided vena cava inferior, dilated azygous vein and large venous ectasia. Congenit Heart Dis. 6(3):262-5, 2011
                                                                              6. Mamidipally S et al: Azygous continuation of inferior vena cava. J Am Coll Cardiol. 56(21):e41, 2010
                                                                              7. Morita S et al: Pelvic venous variations in patients with congenital inferior vena cava anomalies: classification with computed tomography. Acta Radiol. 48(9):974-9, 2007
                                                                              8. Bartram U et al: Heterotaxy syndrome -- asplenia and polysplenia as indicators of visceral malposition and complex congenital heart disease. Biol Neonate. 88(4):278-90, 2005
                                                                              9. Demos TC et al: Venous anomalies of the thorax. AJR Am J Roentgenol. 182(5):1139-50, 2004
                                                                              10. Plata-Muñoz JJ et al: Polysplenia syndrome in the adult patient. Case report with review of the literature. Ann Hepatol. 3(3):114-7, 2004
                                                                              11. Yilmaz E et al: Interruption of the inferior vena cava with azygos/hemiazygos continuation accompanied by distinct renal vein anomalies: MRA and CT assessment. Abdom Imaging. 28(3):392-4, 2003
                                                                              12. Bass JE et al: Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. Radiographics. 20(3):639-52, 2000
                                                                              13. Applegate KE et al: Situs revisited: imaging of the heterotaxy syndrome. Radiographics. 19(4):837-52; discussion 853-4, 1999
                                                                              14. Gayer G et al: Polysplenia syndrome detected in adulthood: report of eight cases and review of the literature. Abdom Imaging. 24(2):178-84, 1999
                                                                              15. Jelinek JS et al: MRI of polysplenia syndrome. Magn Reson Imaging. 7(6):681-6, 1989
                                                                              16. Munechika H et al: Hemiazygos continuation of a left inferior vena cava: CT appearance. J Comput Assist Tomogr. 12(2):328-30, 1988
                                                                              17. Cohen MI et al: Accessory hemiazygos continuation of left inferior vena cava: CT demonstration. J Comput Assist Tomogr. 8(4):777-9, 1984
                                                                              18. Schultz CL et al: Azygos continuation of the inferior vena cava: demonstration by NMR imaging. J Comput Assist Tomogr. 8(4):774-6, 1984
                                                                              19. Siegfried MS et al: Diagnosis of inferior vena cava anomalies by computerized tomography. Comput Radiol. 7(2):119-23, 1983
                                                                              20. Allen HA et al: Case report. Left-sided inferior vena cava with hemiazygos continuation. J Comput Assist Tomogr. 5(6):917-20, 1981
                                                                              21. Ginaldi S et al: Absence of hepatic segment of the inferior vena cava with azygous continuation. J Comput Assist Tomogr. 4(1):112-4, 1980
                                                                              22. O'Reilly RJ et al: The lateral chest film as an unreliable indicator of azygos continuation of the inferior vena cava. Circulation. 53(5):891-5, 1976