Transposition of the Inferior Vena Cava (IVC) in a Patient with an Infrarenal Abdominal Aortic Aneurysm (AAA)

Abstract

Computed tomography angiography in a 65 year old complaining of right sided abdominal pain with a palpable expansile mass revealed a 5 cm abdominal aortic aneurysm (AAA) and hydronephrotic right kidney secondary to calculus. Transposition of the inferior vena cava (IVC) was noted (A, white arrow). The confluence of the common iliac veins gives rise to the IVC at the level of L5 vertebral body. The left sided IVC crosses the aorta at the level of the left renal vein obscuring the aneurysm neck (B, white arrow). This anomaly has a prevalence of 0.3% and is significant at open repair as IVC transection and reconstruction may be required. Endovascular repair negates this challenge.Image 1