Left Inferior Vena Cava (IVC)

Axial contrast-enhanced CT images show the left IVC (arrows) crossing the midline from left to right of the aorta, joining the left renal vein that units with the right renal vein to be a normal right sided suprarenal IVC. Image at the lower section shows the IVC located to the left of the aorta. Without scrutinization, this anomaly can be misdiagnosed as left paraaortic adenopathy.

Facts: IVC Anomalies

• As many as 14 forms of IVC anomalies are theoretically possible
• More than one anomaly can coexist in a patient, for example, double IVC + retroaortic right renal vein + hemiazygos continuation
• Common anomalies are circumaortic left renal vein, retroaortic left renal vein, left IVC, double IVC, azygos continuation of IVC

Left IVC

• Regression of the right supracardinal vein with persistence of the left supracardinal vein
• Prevalence 0.2% - 0.5%
• Left IVC joins the left renal vein, which crosses anterior to the aorta and units with the right renal vein to form a normal right sided suprarenal IVC.
• Clinical significance: potential for misdiagnosis as left paraaortic adenopathy, difficulty placement of IVC filter

Reference:

Bass JE, Redwine MD, Kramer LA, et al. Spectrum of congenital anomalies of the inferior vena cava: cross-sectional imaging findings. RadioGraphics 2000;20:639-652.