A South Indian Cadaveric Study About the Relationship of Hepatic Segment of Inferior Vena Cava with the Liver

Abstract

Introduction: Inferior Vena Cava (IVC) is the largest vein of the body. It runs vertically upwards in the abdomen, behind the liver. Its course is very constant in relation to liver. However, the amount of liver parenchyma related to it can vary from person to person. The data regarding its course and relations may be very useful to radiologists and surgeons during surgical treatment procedures for Budd-Chiari syndrome, liver carcinoma, liver transplant, venous cannulations and many other clinical procedures.

Aim: Aim of this study was to document the incidence of straight and curved course of IVC in relation to liver and also to note the pattern in which the liver tissue was related to the IVC.

Materials and methods: In the current study, 95 adult cadaveric livers were observed; specifically to study the course/direction of the hepatic segment of IVC in relation to the liver. The extent of liver tissue related to various aspects of IVC was also studied. The course of the IVC was classified as straight and curved; and the relationship of liver parenchyma to the IVC was classified into 6 categories. The data was expressed as percentage incidence.

Results: In 78.94% cases, the IVC had a straight course in relation to the liver; whereas in 21.06% cases, it had a left sided curve (concavity of the curve towards the caudate lobe) in its course. In 6.31% cases, IVC travelled in a tunnel, being encircled by the liver parenchyma all around; in 36.84% cases, it was covered by liver parenchyma on front and sides so that only posterior surface of IVC was visible; in 3.15% cases it was covered by liver tissue on front, sides and also partly on posterior aspect; in 50.52% of cases, its anterior surface, sides and left edge of the posterior surface was covered by liver tissue; and in 3.15% cases it was covered only from the front by the liver tissue.

Conclusion: The data being reported here might be useful for surgeons while planning and executing various hepatic surgeries and also to the radiologists in planning and performing venous cannulation and therapeutic procedures. Since in many livers, the curvature of IVC was associated with enlarged caudate lobe, the curved IVC could hint about the increase in the volume of caudate lobe or liver itself.

Keywords: Caudate lobe; Cavoplasty; Variation; Venoplasty.

[Table/Fig-3]:

Photograph of posterior surface of the liver showing left sided curve of the inferior Vena Cava (IVC). (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-4]:

Photograph of posterior surface of the liver showing liver tissue incompletely covering the posterior surface of the inferior Vena Cava (IVC). (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-5]:

Photograph of posterior surface of the liver showing liver tissue encircling the inferior Vena Ccava (IVC). (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-6]:

Photograph of posterior surface of the liver showing liver tissue encircling the posterior surface of the inferior Vena Cava (IVC). (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-7]:

Photograph of posterior surface of the liver showing liver tissue partially covering the posterior surface of the inferior vena cava (IVC) from left and right. (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-8]:

Photograph of posterior surface of the liver showing liver tissue partially covering the posterior surface of the inferior vena cava (IVC) from left and right. (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-9]:

Photograph of posterior surface of the liver showing liver tissue covering the posterior surface of the inferior Vena Cava (IVC) from the left side only. (LL – left lobe; CL – caudate lobe; RL – right lobe)

[Table/Fig-10]:

Photograph of posterior surface of the liver showing the inferior vena cava (IVC) which is covered by liver only on its front surface. (LL – left lobe; CL – caudate lobe; RL – right lobe)