NARROWING OF THE UPPER ABDOMINAL INFERIOR VENA-CAVA IN PATIENTS WITH ELEVATED INTRAABDOMINAL PRESSURE

Background: Previous investigators have suggested that narrowing of th e suprahepatic inferior vena cava (IVC) occurs in patients with increa sed intraabdominal pressure (IAP). Subjects and methods: We retrospect ively reviewed 59 contrast-enhanced computed tomographic (CT) scans pe rformed over a 2-year period in patients with evidence of increased IA P. We also reviewed CT scans performed in a control group of 30 normal patients. The intrahepatic and suprahepatic IVC segments were assesse d for narrowing, Results: Narrowing of the suprahepatic IVC was never observed in the patients with elevated IAP. Slit-like narrowing of the upper intrahepatic IVC was noted in 11 (44%) of 25 patients; the intr ahepatic IVC was not evaluated in 34 other patients with liver abnorma lities or unsatisfactory opacification of the intrahepatic IVC. In con trol subjects, narrowing was not observed in either the intrahepatic o r suprahepatic IVC, Conclusion: Narrowing of the upper intrahepatic IV C can be seen in some patients with increased IAP. The cause and signi ficance of this phenomenon remain to be determined.