Azygos Vein Enlargement on the Chest Film

Abstract

<h3>Common</h3> Absence or obstruction of the inferior vena cava (eg, azygos continuation) Congestive heart failure [Enlarged azygos node; mediastinal tumor] Obstruction of the superior vena cava Portal hypertension; splenic or portal vein thrombosis <h3>Uncommon</h3> Arteriovenous fistula Constrictive pericarditis Idiopathic Pericardial effusion Pregnancy Total anomalous pulmonary venous return to the azygos vein Traumatic azygos aneurysm Tricuspid insufficiency (Entities in brackets may be confused roentgenographically with azygos vein enlargement.) <h3>Diagnosis</h3> Azygos vein enlargement caused by thrombosis of the vena cava and portal and splenic veins. <h3>Comment</h3> A 45-year-old man was admitted to the emergency room for evaluation of psychiatric problems. A routine anteroposterior chest roentgenogram (Fig 1) showed marked enlargement of the azygos vein (20 mm in width, white arrows). An azygos lobe and fissure were also found (Fig 1, black arrow). There was no appreciable cardiac enlargement