Aneurysm of the Inferior Vena Cava: Imaging Findings

Case Series

Austin J Radiol. 2016; 3(3): 1053.

Aneurysm of the Inferior Vena Cava: Imaging Findings

Mehmet Haydar Atalar*

Department of Radiology, Cumhuriyet University School of Medicine, Turkey

*Corresponding author: Mehmet Haydar Atalar, Department of Radiology, Cumhuriyet University School of Medicine, Sivas, TR-58140, Turkey

Received: August 09, 2016; Accepted: September 07, 2016; Published: September 08, 2016


Aneurysms of the Inferior Vena Cava (IVC) are very rare. An IVC aneurysmmay be discovered incidentally in asymptomatic patients on imaging studies performed for other reasons. Its clinical presentation is variable. Ultrasonography (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are the modalities of choice for diagnosis. In this report, we describe two cases with a large fusiform aneurysm of the infrahepatic IVC. Despite being rare, IVC aneurysm should be remembered in patients with right upper abdominal quadrant pain and lower extremity swelling. It can be easily diagnosed by non-invasive cross-sectional imaging methods such as US and MSCT.

Keywords: Aneurysm; Computed tomography; Inferior vena cava; Ultrasonography


Inferior Vena Cava (IVC) aneurysm is quite a rare vascular lesion. It may manifest with a variety of signs and symptoms. While it may be complicated by thromboembolism, it may also remain clinically silent. These aneurysms can be easily diagnosed by Ultrasonography (US), Computed Tomography (CT), or Magnetic Resonance Imaging (MRI) [1-3]. This case report presents the findings of ultrasonography and Multi Slice Computed Tomography (MSCT) in a rare case of IVC aneurysm with a review of the relevant literature.

Case 1

A 76-year-old woman presented with blunt pain confined to right upper abdominal quadrant for about two years. On physical examination she had modest pain on right upper abdominal quadrant and swelling at the same localization as her pain, but her physical examination was otherwise normal. Her laboratory tests also revealed normal results. She had not undergone any previous surgical or interventional procedure. Ultrasonography and Color Doppler US (CDUS) examinations showed a retroperitoneal vascular mass of 7 cm in diameter, which shifted right kidney. The mass was located to IVC region above renal veins, from where it liver parenchyma and extended to right renal vein (Figure 1A&B). In order to determine the extent of the mass and detect other possible concurrent pathologies, abdominal computed tomography imaging was performed at delayed arterial and venous post-contrast phases with a 16-detectorMSCT device (Brilliance 16, Philips Medical Systems, Best, Netherlands) and evaluated on axial, sagittal and coronal planes. The lesion was detected to be a large saccular aneurysm of the intrahepatic-suprarenal IVC. There were areas of heterogeneous density due to turbulence within the lesion, but no intraluminal filling defects. Intrahepatic veins were also dilated, and dilatation continued up to the right heart. The right kidney and adrenal gland were displaced inferiorly, and the left lobe of the liver was compressed (Figures 2A&B). Dilatation and tortuosity of splenic vein and subcutaneous vascular structures on the anterior abdominal wall were considered secondary to the intrahepatic pressure increase. Multimodality imaging confirmed the diagnosis of IVC aneurysm. No pathology was found in other organs and venous systems, including both renal veins.