Aortic ectasia with hemiazygos vein dilatation: a mimicker of aortic dissection

Infrahepatic interruption of the inferior vena cava (IVC) is a rare but well-documented finding. In this condition, the IVC between renal and hepatic vein is absent and the hepatic veins directly empty into the right atrium; because of the enlargement of the azygos-hemiazygos vein system, this condition could mimic aortic pathology. We will describe a case of aortic arch enlargement with dilatation of hemiazygos vein, which was initially misdiagnosed by two-dimensional transesophageal echocardiography (TEE) as aortic dissection. TEE-Doppler identified the real condition, which was confirmed by computed tomography.