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Duplicate inferior vena cava complicating the evaluation of primary aldosteronism
  1. Graham J Spurzem1,
  2. Michael A Taddonio2,
  3. Tamara T Rubenzik3 and
  4. Michael Bouvet4
  1. 1Surgery, University of California San Diego School of Medicine, La Jolla, California, USA
  2. 2Radiology, University of California San Diego, La Jolla, California, USA
  3. 3Medicine, University of California San Diego, La Jolla, California, USA
  4. 4Surgery, University of California San Diego, La Jolla, California, USA
  1. Correspondence to Mr Graham J Spurzem; gspurzem{at}


A 64-year-old man with a known duplicate inferior vena cava (D-IVC) and resistant hypertension presented to our emergency department in a hypertensive crisis. He had a longstanding history of hypertension and unexplained hypokalemia treated with oral potassium supplementation. The patient was diagnosed with primary aldosteronism and MRI of the abdomen revealed a left-sided adrenal adenoma. Adrenal venous sampling (AVS) lateralised aldosterone hypersecretion to the left adrenal gland. The patient subsequently underwent an uncomplicated laparoscopic left adrenalectomy. The patient’s postoperative course was uneventful, and he was discharged on a single antihypertensive medication on postoperative day 1. D-IVC is one of several rare IVC anatomical variants that have been well described in the literature. Knowledge of this patient’s unique abdominal venous anatomy enabled successful AVS and appropriate surgical management. It is necessary to identify potential anatomical variants of abdominal venous anatomy that may complicate these invasive procedures.

  • interventional radiology
  • surgical oncology
  • adrenal disorders

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  • Contributors MB performed the laparoscopic adrenalectomy. MAT performed the adrenal venous sampling. TTR managed the patient medically. GJS wrote the report with input from all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.