Inferior Vena Cava, Portal and Hepatic Venous Systems

Due to advances in non-invasive vascular imaging, anatomic variants and anomalies of the inferior vena cava (IVC) have become more commonly recognized in routine practice. Anomalies of the IVC have been described more frequently in those with other cardiovascular defects, and less frequently in otherwise healthy individuals. Their embryological basis is incompletely understood with the aetiology of infrarenal interrupted IVC being particularly controversial, thought most likely to be the result of perinatal IVC thrombosis. Knowledge of the anatomic variants of the portal and hepatic veins is of prime importance for precise lesion localization, insertion of a transjugular intrahepatic portosystemic shunt (TIPS), and in planning liver transplantation. The impact of hepatic venous anatomic variations on hepatic resection and transplantation is the least understood aspect of liver surgery. The right hepatic vein may pass through the caval diaphragmatic opening before joining the IVC.