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September 1978

Radiological Case of the Month

Author Affiliations

From the Departments of Radiology, Hahnemann Hospital (Dr Mandell), and the Thomas Jefferson University Hospital (Dr O'Hara), Philadelphia.

Am J Dis Child. 1978;132(9):921-922. doi:10.1001/archpedi.1978.02120340097020

Cinical History.—A 5½-month-old infant was admitted to the Thomas Jefferson University Hospital because of persistent diarrhea for four weeks. The patient was the product of a full-term gestation and a vaginal delivery. The birth weight was 3,060 g. There was an uneventful neonatal course without history of anemia or jaundice.

Physical Examination.—Results of physical examination were unremarkable. Roentgenograms of the abdomen were obtained because of the gastrointestinal history (Fig 1 and 2). Subsequent evaluation included an intravenous urogram (Fig 3) and inferior vena cavogram (Fig 4). Findings from laboratory data, including catecholamines and titers for rubella and cytomegalic inclusion disease were negative.

Denouement and Discussion 

Presumptive Benign Intra-abdominal Calcifications: Adrenal and Inferior Vena Cavai  A bullet-shaped calcification appearing in the right upper quadrant of the abdomen is a rare finding, but quite characteristic of a thrombosis of the inferior vena cava. To our knowledge, eight cases have been reported in the literature. Infection, neoplasia in the area of the vena cava or liver, and structural anomaly of the venous conduit1 may produce thrombosis. Thrombosis of the inferior vena cava is usually detected as an incidental finding.

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