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Split Azygos Vein: A Case Report.

Stefan Lachkar¹, Joe Iwanaga², Emma Newton²

¹Anatomy, Seattle Chirdren's, Seattle, USA.

|March 22, 2021

Summary

A rare split azygos vein was discovered during cadaver dissection, originating from the inferior vena cava. This anatomical variation highlights the importance of understanding venous system anomalies for surgical safety.

Keywords:

anatomy azygos vein cadaver embryology inferior vena cava variation

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Area of Science:

Anatomy
Vascular Anatomy
Human Anatomy

Background:

The azygos venous system, comprising the azygos, hemiazygos, and accessory hemiazygos veins, is crucial for draining blood from the thoracic cage and posterior mediastinum into the superior vena cava (SVC).
Understanding the typical anatomy of this system is fundamental in medical and surgical fields.

Observation:

Routine dissection of a fresh-frozen cadaveric specimen revealed an unusual anatomical variation: a split azygos vein.
The azygos vein originated as a single trunk from the inferior vena cava (IVC) at the level of the second lumbar vertebra.

Findings:

Following its origin from the IVC, the single azygos trunk bifurcated into two tributaries after forming a venous plexus.
The right-sided tributary of this split system drained into the SVC, while the inferiorly located collective system drained back into the IVC.

Implications:

Anatomical variations in the venous system, particularly the vena cavae and associated veins like the azygos vein, can predispose to dilation and tortuosity, increasing the risk of injury.
Awareness of such azygos vein variations is critical for surgeons, especially those performing anterior spinal approaches, to prevent iatrogenic complications.