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Inferior vena cava in pathology
Last reviewed: 06.07.2025
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Dilation of the inferior vena cava occurs in right ventricular heart failure. In this case, there is no significant change in diameter during the respiratory cycle, and dilation of the main branches of the inferior vena cava can also be determined.
Compression of the inferior vena cava can be determined by liver tumors, enlarged lymph nodes, or retroperitoneal fibrosis.
Anterior displacement of the inferior vena cava occurs with spinal deformity, spinal abscesses (eg, tuberculous abscess of the lumbar muscle), or a retroperitoneal tumor such as lymphoma.
Blood clots in the inferior vena cava
Clearly defined echogenic structures in the inferior vena cava are due to thrombosis or invasion of the vein by a renal tumor; always check the contours of the kidneys when echogenic structures are detected within the inferior vena cava. A large venous trunk parallel to the course of the inferior vena cava is visualized by dilatation of the ovarian vein or testicular vein. When bright hyperechoic structures with acoustic shadowing are visualized in the lumen of the inferior vena cava, it is necessary to ask the patient whether there is a history of surgery to place a cava filter.
If thrombosis or tumor is suspected, the inferior vena cava should be examined along its entire length before surgery to determine the extent of the lesion. Invasion of the inferior vena cava occurs with renal cell carcinoma, hepatoma, or adrenal cancer. If there is any doubt about the presence of a thrombus, cavagraphy, computed tomography (CT), or magnetic resonance imaging should be performed.
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