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September 1996

Picture of the Month

Author Affiliations

From the Departments of Pediatrics (Drs Wenzl, Skopnik, and Heimann) and Diagnostic Radiology (Dr Alzen), University Hospital, Technical University Aachen, Aachen, Germany; and the American Board of Pediatrics, Chapel Hill, NC (Dr Tunnessen).

Arch Pediatr Adolesc Med. 1996;150(9):995-996. doi:10.1001/archpedi.1996.02170340109021

AT BIRTH, a large, dilated subcutaneous vein was noticed running across the lower abdomen from the left groin to the right lateral thorax and into the right axilla in a female infant (Figure 1 and Figure 2). The physical examination results were otherwise unremarkable. The mother's pregnancy, labor, and delivery were uncomplicated and there was no family history of congenital abnormalities. Figure 3, Figure 4, and Figure 5 are part of a venogram performed after injection of contrast into the lower extremities.

Denouement and Discussion  Congenital Discontinuity of the Inferior Vena CavaChronic obstruction of deep veins often leads to the development of subcutaneous collateral veins presenting as diffuse webs of small vessels. Intrauterine thrombosis or agenesis of the inferior vena cava is compensated for by the development of deep and superficial collateral veins. It is highly unusual for the collateral drainage to be in the form of a single

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