Discussion:
The inferior vena cava (IVC) allows the drainage of venous blood from
the lower limbs and abdominal organs to the right atrium. Knowledge of
its anatomical variants is essential for subsequent therapeutic
management (3). So that hemorrhagic complications during retroperitoneal
surgery can be avoided. The IVC variations are frequently detected by CT
scan as it is widely used to explore diverse abdominal symptoms. The IVC
is formed essentially of 4 segments: the hepatic, suprarenal, renal, and
infrarenal IVC (4). During embryonic life, the IVC genesis occurs
between weeks 6 and 10 of gestation. It is a complex procedure involving
different anastomosis and veins regression. The persistence of both
supracardinal veins forming duplicated infrarenal IVC segments leads to
IVC duplication (5). The left infrarenal IVC joins the left renal vein
and drains into a normal suprarenal IVC. This abnormality is found in
0.2-3% of the general population (5). It is classified in 3 types. The
major duplication or type I, where 2 symmetric trunks are observed with
the same caliber as the preaortic trunk. The minor duplication or type
II, where also two symmetric trunks but which are smaller than the
preaortic trunk. And the asymmetric duplication or type III, with a
smaller left IVC and a larger right (6).
The diagnosis of IVC duplication happens usually during retroperitoneal
surgery as it is often asymptomatic. But it can have clinical impact
such as recurrent thromboembolism despite an IVC filter (7). In other
instances like transplant surgery, it is important de be aware of this
anatomical variantion (7). It is also important to be aware about this
abnormality in order to avoid hemorrhagic complications during
retroperitoneal surgery (9). Fortunately, in our case, the post
operative outcome was favorable and no bleeding was noted.