Abstract
A 3-year-old child received a diagnosis of asymptomatic hepatomegaly by his primary care physician. Subsequent computed tomography (Fig 1; L = liver) was consistent with fibrotic liver changes. This finding was confirmed by liver biopsy, which also revealed passive venous congestion. The patient subsequently underwent an angiogram (Fig 2 ; D = diaphragm), which demonstrated complete occlusion of the inferior vena cava at the junction of the right atrium (single arrow). Patent hepatic veins do appear, although several collaterals (double arrow) from the hepatic system to the hemiazygous system are evident. Echocardiography showed normal intracardiac anatomy.
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