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Official Journal of the Italian College of Phlebology
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Acta Phlebologica 2006 April;7(1):23-5

language: English

Abnormal azygos venous system associated with left sided thoracic duct: a case of multiple variations

Pai M., Rajanigandha V., Krishnamurthy A., Prabhu L., L. Ramanathan L.

Department of Anatomy, Center for Basic Sciences, Kasturba Medical College, Bejai, Mangalore, India


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A case of multiple variations of the azygos venous system along with abnormality in the course of thoracic duct was detected during routine anatomic dissection of the posterior mediastinum of adult male cadaver. The right ascending lumbar vein united with the subcostal vein and formed the azygos vein which presented an abnormal course. The azygos vein ran obliquely, briefly lying in the midline, to cross the vertebral column at the level of 9th thoracic vertebra and ascended upwards on its left side. The vein then coursed back to the right side at the level of 5th thoracic vertebra, arched over the hilum of the right lung and terminated in the superior venacava. The hemiazygos vein was quite narrow in diameter, but received its usual tributaries and communicated with the azygos vein twice. An anomalous oblique communication channel connected the accessory hemiazygos with the hemiazygos vein. The entire course of the thoracic duct was observed to be on the left side. Accurate descriptions of venous connections and lymphatic system have importance in mediastinal surgeries.

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