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Journal of Ultrasound in Medicine, Vol 14, Issue 5 381-387, Copyright © 1995 by American Institute of Ultrasound in Medicine
Azygous continuation of the interrupted inferior vena cava: a clue to prenatal diagnosis of the cardiosplenic syndromes
R. C. Sheley, D. A. Nyberg and R. Kapur
Department of Ultrasound, Swedish Hospital Medical Center, Seattle, Washington, USA.
We reviewed the prenatal sonographic findings in 11 consecutive fetuses
diagnosed as having abdominal situs inversus (stomach on the right) at a
single institution. Interruption of the inferior vena cava with azygous
continuation was diagnosed by the "double vessel" sign. This sign was
considered to be present in nine cases, including all eight fetuses who
proved to have the polysplenia syndrome. The only false positive diagnosis
of IVC interruption with azygous continuation was made prospectively in one
fetus with asplenia. At autopsy, this fetus showed a large left-sided
superior vena cava. We conclude that, in combination with cardiac anomalies
or situs abnormalities, interruption of the IVC with azygous continuation
should suggest a specific diagnosis of a cardiosplenic syndrome, especially
polysplenia. This information should be helpful in patient counseling and
management.
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