POST COVID EXTENSIVE VENOUS THROMBOSIS IN A PATIENT HAVING INFRAHEPATIC INTERRUPTION OF THE INFERIOR VENA CAVA (IVC) WITH AZYGOS CONTINUATION

Abstract

The failure of the hepatic and prerenal segments of the inferior vena cava (IVC) to merge during embryological development, leading to the persistence of either the azygous or hemiazygous vein, results in the rare condition "infrahepatic interruption of the IVC with azygos continuation" (0.6% prevalence). This anomaly is predisposed to IVC thrombosis due to restricted blood flow, resulting in venous hypertension, stasis, and thrombosis. Notably, hypercoagulability is a concern in COVID-19 patients. Here, we present a case of extensive post-COVID venous thrombosis in a 25-year-old male with infrahepatic interruption of the IVC and azygos continuation, following COVID-19 infection. The patient reported back pain and abdominal discomfort, with an MRI of the lumbar spine revealing extensive venous thrombosis in the IVC and iliofemoral veins, along with multiple venous collaterals. Subsequent contrast-enhanced CT imaging confirmed severe IVC stenosis or interruption, iliofemoral venous thrombosis, and azygous and hemiazygous connections. Radiologists must maintain a comprehensive understanding of the diverse congenital IVC anomalies to prevent diagnostic inaccuracies, and this knowledge proves equally crucial for surgeons and cardiologists in the context of preoperative planning.

 Keywords:

Inferior venacava anomalies, azygos vein continuation, COVID-19 complications.