Bilateral duplicated inferior vena cava associated with aberrant internal iliac and gonadal veins: A case-based narrative review

Background: The left side anterior retroperitoneal approach is preferred for the management of lumbosacral spine disorders as there is reduced risk for vascular injury. The presence of multiple and uncommon venous variations on either side of the spine, like the bilateral duplicated inferior vena cava (DIVC), may complicate surgery in this region. The current study describes two rare cases of bilateral duplicated inferior vena cava associated with internal iliac and gonadal veins. Methods: The cases were identified during routine human dissections of the posterior abdominal wall of 89 (45 males, 44 females) individuals. The course, relations and morphometry of each duplicated inferior vena cava were examined and recorded. Results: Two (2.2%) of the 89 (1 male, 1 female) dissected individuals showed the presence of bilateral duplicated infrarenal segments of the inferior vena cava. In both cases, the pre-aortic trunk (vein) was the largest and the left inferior vena cava was the smallest. Both cases of bilateral DIVC presented with anomalous interiliac communicating veins, internal iliac veins, and drainage sites of the left gonadal veins. Conclusions: The duplicated inferior vena cava may present with associated venous anomalies like those related to the gonadal and internal iliac veins. Knowledge of the duplicated inferior vena cava and its associated venous anomalies may be essential for accurately identifying and diagnosing vascular dysfunction and improving radiological interpretation across multiple surgical specialities.