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.