Abstract
Inferior vena cava (IVC) is a large collapsible vein whose diameter and extent of inspiratory collapse are known to correlate with right atrial (RA) pressures; hence, IVC dilatation represents a cardiac pathology. IVC dilatation in the absence of any cardiac involvement is termed as idiopathic. We report a case of a 39-year-old male who presented with abdominal pain and had an incidental finding of isolated IVC dilatation with diminished inspiratory collapsibility and normal RA pressures. This case report emphasizes that IVC dilatation may not always have an underlying cardiac pathology.
Highlights
Inferior vena cava (IVC) is a compressible vessel whose diameter is subjective to changes in both the intrathoracic pressure during breathing and the systemic venous return [1]
The IVC diameter is affected by right heart function, as well as conditions like IVC aneurysm or Budd-Chiari syndrome (BCS), which directly or indirectly increase the volume of the blood in the right heart or increase the back pressure on the systemic circulation leading to IVC dilation [2,3]
Detailed workup is warranted in cases of increased IVC diameter to find out the underlying etiology, increased IVC diameter is not always related to underlying pathology as there have been cases of young athletes who reported with dilated IVC diameters but with no underlying medical pathology
Summary
Inferior vena cava (IVC) is a compressible vessel whose diameter is subjective to changes in both the intrathoracic pressure during breathing and the systemic venous return [1]. Known case of celiac disease, presented with abdominal pain and underwent an ultrasound abdomen, which revealed an incidental finding of dilated IVC with normal RA pressures on echocardiography done later. He was given intravenous antispasmodic injection and intravenous fluids His baseline labs, including complete blood count, liver function test, renal function test, urine routine examination, stool routine examination and microscopy (for ova and cysts) and coagulation profile, were sent from the ED, and all results were within normal limits. His ultrasound abdomen reported a normal study with no evidence of gallstones, pericholecystic fluid or inflammation of the pancreas. After assuring no plausible causes of dilated IVC existed, the patient was given the diagnosis of an idiopathic IVC dilation
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