Combined anomaly of the right hepatic lobe agenesis and absence of the inferior vena cava: a case report

Abstract

The absence of the inferior vena cava is an uncommon congenital anomaly that has recently been identified as an important risk factor contributing to the development of deep venous thrombosis. Congenital agenesis of the right hepatic lobe is a rare anomaly which is found incidentally in radiologic examinations. We present a case of a congenital absence of the infrarenal inferior vena cava, combined with agenesis of the right hepatic lobe in a 62-year-old man presented with symptoms of deep venous thrombosis.

Fig. 1

62-years-old patient with right hepatic lobe agenesis, combined with deep venous thrombosis caused by congenital absence of inferior vena cava. A. Coronal thick (30 mm) slab maximum intensity projection CT image showed thrombus (arrowheads) occupying entire lumen of right femoral and external iliac vein. Left hepatic vein (arrow) drains into inferior vena cava (asterisk). B. Transverse CT scan obtained inferior to kidney shows missing IVC. Enlarged left testicular vein (arrow) and prominent anterior abdominal wall collateral veins (arrowheads) are present. C. Transverse contrast-enhanced CT scan obtained at hilus level of left kidney shows missing infrarenal segment belonging to IVC. Enlarged ascending lumbar vein and prominent left testicular vein (arrow) are present. Right hepatic lobe is absent and gallbladder (curved arrow) is identified in retrohepatic position. D. Transverse thick (30 mm) slab maximum intensity projection CT image of arterial phase shows left hepatic artery (large arrow) arising from celiac axis. Complete absence of right hepatic artery branch is noted, along with left portal vein (small arrows). E. Coronal MIP of two-dimensional time-of-flight MR image shows absence of infrarenal IVC, with enlarged azygos (large arrow) and hemiazygos vein (small arrows). Tortuous and enlarged left testicular vein (arrowheads) is also noted.