European Journal of Ultrasound 14 (2001) 179 – 182 Case Report The value of ultrasonography in interrupted inferior vena cava with azygos continuation IsmailMihmanli a, *, Nail Bulakbasi b , Fatih Kantarci a , Ibrahim Adaletli a , Yuksel Pabuscu b a Department of Radiology, Cerrahpasa Medical Faculty, IstanbulUni6ersity, 34300 I : stanbul, Turkey b Department of Radiology, Gu¨lhane Military School of Medicine, Ankara,Turkey Received 21 May 2001; received in revised form 30 July 2001; accepted 15 August 2001 Abstract The cardiosplenic syndromes represent a complex set of abnormalities of the thorax and viscera resulting from abnormal folding of the embryo during early development. Anomalies of venous development include interruption of inferior vena cava (IVC), and in combination with situs inversus referred to as the polysplenia syndrome. We present a 23-year-old male previously diagnosed as having a persistent left IVC on venography whereas ultrasonographic examination clearly demonstrated interrupted IVC with azygos continuation along with situs inversus.© 2001 Elsevier Science Ireland Ltd. All rights reserved. Keywords : Agenesis; Inferior vena cava; Ultrasonography; Situs inversus www.elsevier.com/locate/ejultrasou 1.Case report A 23-year-old malepresented with recurrent thrombophlebitisof the right lower extremity. Pelvic venography in addition to bilateral lower extremity venographic examination showed that the common iliac veinswere draining to a left paravertebrally located venous structure (Fig. 1), thought to be a persistent left inferior vena cava (IVC). One year after the venographic examina- tion the patient presented with abdominal discom- fort and abdominal ultrasonography (US) showed absence of the hepatic and infrahepatic segments of the IVC. The hepatic veins were draining di- rectly into the rightatrium (Fig.2). In the left paravertebral location,a large vascular structure draining both common iliac veins could be fol- lowed up to the diaphragm and was diagnosed as the azygos vein. Both renalveins were draining into this large vascularstructure.Echocardio- graphic examination demonstrated agenesis of the IVC and a dilated azygos vein, which was drain- ing into the superior vena cava, and prolapse of the mitral and tricuspid valves. In addition to * Corresponding author. Tel.: + 90-212-586-1586; fax: + 90-212-632-0044. E-mail address : mihmanli@yahoo.com (I. Mihmanli). 0929-8266/01/$ - see front matter © 2001 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 9 2 9 - 8 2 6 6 ( 0 1 ) 0 0 1 6 0 - 4