title: Membranous IVC Obstruction Presenting with Antegrade/Retrograde Respiratory Flow in the Intrahepatic Segment in Doppler Imaging and Prostatic and Urethral Congestion.
abstract: BACKGROUND
  Obstruction of the inferior vena cava (IVC) is infrequent, membranous obstruction of the IVC (MOIVC) being one of its rare causes. Early diagnosis is important, as it can lead to hepatic congestion, cirrhosis and Budd-Chiari syndrome (BCS) and can predispose to development of hepatocellular carcinoma (HCC) in severe cases.
  
  
  METHODS
  We report a case of membranous IVC obstruction at the junction of hepatic and suprahepatic segments in a young male with extensive collateralization and venous aneurysms. Unique findings involved antegrade and retrograde flow during respiration in the upper part of intrahepatic IVC proximal to a large collateral vein as well as prostatic and urethral congestion leading to intermittent urinary hesitancy, which have not yet been described in such cases.
  
  
  CONCLUSIONS
  MOIVC is a rare cause of IVC obstruction with typical radiological features. Early diagnosis and management is required due to risk of cirrhosis and HCC. Antegrade and retrograde flow may be seen in incomplete MOIVC above the level of a large collateral vein and it may lead to prostatic and urethral congestion.
authors.affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.
authors.forename: Dinesh
authors.initials: D
authors.lastname: Sood
authors.affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.
authors.forename: Kewal A
authors.initials: KA
authors.lastname: Mistry
authors.affiliation: Department of Community Medicine, Dr Rajendra Prasad Government Medical College, Kangra, India.
authors.forename: Veenal
authors.initials: V
authors.lastname: Chadha
authors.affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.
authors.forename: Sarthak
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Radiology, Dr. Rajendra Prasad Government Medical College, Kangra, India.
authors.forename: Parikshit D
authors.initials: PD
authors.lastname: Morey
authors.affiliation: Department of Radiology, Baroda Medical College, Vadodara, India.
authors.forename: Pokhraj P
authors.initials: PP
authors.lastname: Suthar
authors.affiliation: Department of Cardiology, Saint Francis Hospital, Hartford, CT, U.S.A.
authors.forename: Dhruv G
authors.initials: DG
authors.lastname: Patel
keywords: Prostate; Tomography, Spiral Computed; Ultrasonography, Doppler, Color; Vena Cava, Inferior