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Case Reports
. 2023 Jan 26;2023(1):rjad014.
doi: 10.1093/jscr/rjad014. eCollection 2023 Jan.

Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure

Dimosthenis Chrysikos  1 , Spiros Delis  2 , Dimitra Smerdi  1 , Eugenia Charitaki  2 , Eirini Solia  1 , Theodore Troupis  1
Affiliations
Case Reports

Duplicated inferior vena cava-trifurcated portal vein: a rare anatomical variation encountered during Whipple procedure

Dimosthenis Chrysikos et al. J Surg Case Rep. .

Abstract

The inferior vena cava (IVC) is the largest single vein in humans. However, during embryogenesis, abnormalities can occur resulting in a duplicated IVC. The portal vein (PV) offers the main blood flood to the liver, forming by the left and right PV. A number of anatomical variations are noticed, underlying the great importance of the pre-operative imaging workup. This case report presents a duplicated IVC and a trifucated PV that were incidentally found in an 82 year-old Caucasian male with pancreatic ductal adenocarcinoma who underwent pancreatoduodenectomy (Whipple procedure). Although some anatomical variations, including the duplication of the IVC and the trifurcation of PV, may be rare to the general population, the suspicion of their existence should always be taken under consideration from surgeons during hepatobiliary or retroperitoneal operations.

Keywords: anatomical variations; duplicated inferior vena cava; inferior vena cava; trifurcation portal vein.

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Figures

Figure 1
Figure 1
(a) Coronal image from CT with contrast, presenting the duplicated IVC (arrows); (b) transverse image from CT with contrast, presenting the duplicated IVC (arrows).
Figure 2
Figure 2
(a) CT with contrast demonstrating the trifurcated portal vein (arrow); (b) gross appearance of the duplicated IVC intraoperatively (arrow).
Figure 3
Figure 3
(a) Classification of IVC abnormalities; (b) variations of the branching of portal vein. MPV: main portal vein, RPV: right portal vein, LPV: left portal vein, RAPV: right anterior portal vein, RPPV; right posterior portal vein.
See this image and copyright information in PMC

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