Polysplenia syndrome is an embryological disorder whereby the usual left-right asymmetry of thoracic and abdominal viscera fails to develop. It is a rare entity, estimated to occur at a frequency of 1 in 40,000, and is often associated with cardiac and biliary abnormalities. More than 75% of patients die before the age of 5 years, and even in the absence of cardiac anomalies, only 5%-10% of patients are expected to survive into adulthood without complications. Although polysplenia syndrome encompasses a wide range of anatomic abnormalities, there is no single pathognomonic feature. Hence, the prognosis of patients with polysplenia depends on their anatomy, thus necessitating radiology in their management. Here we present a case of a 56-year-old man with polysplenia syndrome and situs inversus totalis. This presentation is atypical because polysplenia is usually considered a form of situs ambiguus, and cases with situs inversus totalis are exceedingly rare. Also noted in our patient are variations in the great vessels, including aortic arch branches and the venae cavae which are features not typically associated with either polysplenia syndrome or situs inversus totalis. The patient is healthy and asymptomatic at baseline, with his diagnosis being made incidentally. Our case report is the first to describe this unique combination of cardiothoracic and cardiovascular anatomy. It also emphasizes the importance of radiologists in caring for patients with laterality defects. As these disorders are uncommon, more data on their anatomic variations may help provide better medical care to this patient population.

Azygos vein aneurysm is a rare thoracic disease that often mimics posterior mediastinum tumors. Pathogenesis of azygos vein aneurysm is unclear. Discussions about possible causes are still ongoing. Most aneurysms are asymptomatic and diagnosed incidentally during standard examinations. Severe complications of azygos vein aneurysm include rupture with massive bleeding and pulmonary embolism. Contrast-enhanced chest CT and MRI are essential. Differential diagnosis includes tumors, cysts and rare neoplasms of the mediastinum. Treatment algorithm is not established. There are traditional surgical and endovascular methods. We present minimally invasive surgical treatment of azygos vein aneurysm in a 53-year-old woman. The patient underwent thoracoscopic resection of aneurysm. Histological examination revealed a partially thrombosed azygos vein aneurysm.
Аневризма дуги непарной вены представляет собой редкое заболевание в грудной полости, которое зачастую скрывается под маской опухолевого новообразования заднего средостения. Патогенез аневризмы непарной вены до конца не описан, дискуссии о возможных причинах развития ведутся до сих пор. Большинство наблюдений аневризм протекают бессимптомно и их диагностируют случайно при стандартных медицинских обследованиях. Среди грозных осложнений аневризмы непарной вены описаны разрыв с развитием массивного кровотечения и тромбоэмболия легочной артерии. Наибольшую диагностическую ценность имеют компьютерная и магнитно-резонансная томография органов грудной клетки с контрастированием. Дифференциальную диагностику проводят с опухолями, кистами и редкими новообразованиями средостения. Лечебный алгоритм не определен, описаны как традиционные хирургические методы лечения, так и эндоваскулярные. В настоящей работе представлено клиническое наблюдение хирургического малоинвазивного лечения аневризмы дуги непарной вены с клиническими проявлениями у 53-летней женщины. Пациентке была выполнена торакоскопическое удаление аневризмы дуги непарной вены. По результатам гистологического исследования выявлена частично тромбированная аневризма дуги непарной вены.

Intrahepatic interruption of the inferior vena cava (IVC) with continued hemizygous is a very rare abnormality and sometimes it may be accompanied by other cardiovascular abnormalities. Continuation of the hemizygous vein draining into the right atrium through the left superior vena cava (LSVC) is much rarer. In this paper, we have presented a patient who had simultaneous IVC interrupted with persistent LSVC and suffered from Atrioventricular nodal reentrant tachycardia (AVNRT). Finally, radiofrequencies (RF) catheter ablation for AVNRT was successfully performed through a left subclavian vein access.

暂无摘要。

The isolated absence of the azygos vein was incidentally found on computed tomography (CT) examination in a 60-year-old female. The exact anomaly can be evaluated on high-resolution images of 0.4-mm slice thickness with low keV using photon-counting detector CT. The azygos vein, including the azygos arch, was absent, and a mildly dilated hemiazygos vein flowed to the left brachiocephalic vein through the left superior intercostal vein. A hemiazygos vein connected the left renal vein at the level of the first lumbar vertebra. This patient was the second patient to undergo evaluation using volume rendering images. High-resolution maximum-intensity projection images were useful for assessing the anatomy. Radiation dose was decreased compared with that in conventional CT.

Congenital anomalies of respiratory system are quite diverse and not all of them are subject to surgical treatment. One example is accessory lobe of the azygos vein. This anomaly usually has no clinical manifestations and requires only follow-up, as well as attention in surgery on the right half of the chest for some other disease. This situation changes when complications occur, for example, purulent-inflammatory process. Therapy is not always effective, and lung tissue destruction requires surgical treatment. Progressive destruction complicates diagnosis and choosing surgical tactics. We present a rare case of severe purulent-inflammatory complication with abscess in accessory lobe of v. azygos. Anatomical abnormalities following this congenital pulmonary anomaly can cause difficulties in surgeries for other intra-thoracic diseases. The situation is especially relevant for thoracoscopic access. This report will be useful for radiologists, pulmonologists and thoracic surgeons.
Врожденные аномалии развития органов дыхания достаточно разнообразны, и не все они подлежат хирургическому лечению. Одним из таких примеров считается добавочная доля непарной вены, которая в большинстве случаев не имеет клинических симптомов и требует лишь динамического наблюдения, а также учета при планировании операций на органах грудной клетки через правосторонний доступ. Ситуация кардинально меняется в случае возникновения осложнений. Как правило, это проявляется гнойно-воспалительным процессом вследствие прежде всего нарушения дренажной функции бронха. Не всегда воспаление может быть купировано консервативной терапией, что приводит к деструкции легочной ткани и требует уже хирургического вмешательства. Ситуации с прогрессирующим гнойно-деструктивным воспалением ввиду редкого возникновения данного осложнения могут вызвать трудности как при дифференциальной диагностике, так и при выборе хирургической тактики. Представлен редкий случай тяжелого гнойно-воспалительного осложнения с формированием абсцесса в добавочной доле непарной вены. Изменения топографической анатомии при данной врожденной аномалии могут вызвать затруднения и при выполнении операций по поводу других внутриторакальных хирургических болезней. Ситуация особенно актуальна при торакоскопическом доступе. Данная публикация будет полезной для врачей-рентгенологов, врачей-пульмонологов и врачей — торакальных хирургов.

暂无摘要。

UNASSIGNED: Peripherally inserted central catheters (PICCs) are frequently utilized for extended intravenous treatments. However, complications such as incorrect placement into the azygos vein can result in significant health issues. A thorough understanding of these aspects is crucial to enhance the safety and effectiveness of PICC procedures, thereby improving patient care outcomes.
UNASSIGNED: The research was conducted on a cohort of 12 patients who experienced PICC malposition into the azygos vein. Systematically reviewed information on classification, imaging manifestations, potential influencing factors, and methods for identification, prevention, and management.
UNASSIGNED: The analysis uncovered two PICC malposition classifications within the azygos vein, each with unique imaging characteristics. It also pinpointed several factors influencing malposition, offering valuable insight into potential risks. Moreover, it established effective detection methods, underscoring the significance of imaging techniques. Additionally, it outlined strategies for preventing and managing PICC malposition in the azygos vein, enhancing overall comprehension of the issue.
UNASSIGNED: The findings emphasize the importance of taking a proactive stance to avoid malposition and stress the necessity of prompt and precise intervention when malposition does happen, thereby enhancing the safety and effectiveness of PICC processes.

UNASSIGNED: Segmental aplasia of the caudal vena cava (CVC) with azygos continuation is a congenital malformation macroscopically described in mammals including humans, dogs, and rodents. It is usually detected as an incidental finding and the final diagnosis is reached by computed tomography (CT), fluoroscopy, or post-mortem dissection.
UNASSIGNED: A 3-year-old guinea pig (Cavia porcellus) presented with subacute dyspnea. A computed tomographic examination was performed for the evaluation of subtle pulmonary changes previously suspected on conventional radiography, and a segmental aplasia of the CVC with azygos continuation was identified as an incidental finding.
UNASSIGNED: According to database negative results, this is the first report describing a segmental aplasia of the CVC and azygos continuation in a guinea pig by CT.

BACKGROUND: The malposition of central venous catheters (CVCs) may lead to vascular damage, perforation, and even mediastinal injury. The malposition of CVC from the right subclavian vein into the azygos vein is extremely rare. Here, we report a patient with CVC malposition into the azygos vein via the right subclavian vein. We conduct a comprehensive review of the anatomical structure of the azygos vein and the manifestations associated with azygos vein malposition. Additionally, we explore the resolution of repositioning the catheter into the superior vena cava by carefully withdrawing a specific length of the catheter.
METHODS: A 79-year-old female presented to our department with symptoms of complete intestinal obstruction. A double-lumen CVC was inserted via the right subclavian vein to facilitate total parenteral nutrition. Due to the slow onset of sedative medications during surgery, the anesthetist erroneously believed that the CVC had penetrated the superior vena cava, leading to the premature removal of the CVC. Postoperative contrast-enhanced computed tomography of the chest confirmed that the central venous catheter had not penetrated the superior vena cava but malpositioned into the azygos vein. The patient was discharged 15 days after surgery without any complications.
CONCLUSIONS: CVC malposition into the azygos vein is extremely rare. Clinical practitioners should be vigilant regarding this form of catheter misplacement. Ensuring the accurate positioning of the CVC before each infusion is crucial. Utilizing chest X-rays in both frontal and lateral views, as well as chest computed tomography, can aid in confirming the presence of catheter misplacement.