Narrowing of the upper abdominal inferior vena cava in patients with elevated intraabdominal pressure

Background: Previous investigators have suggested that narrowing of the suprahepatic inferior vena cava (IVC) occurs in patients with increased intraabdominal pressure (IAP). Subjects and methods: We retrospectively reviewed 59 contrast-enhanced computed tomographic (CT) scans performed over a 2-year period in patients with evidence of increased IAP. We also reviewed CT scans performed in a control group of 30 normal patients. The intrahepatic and suprahepatic IVC segments were assessed 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 intrahepatic IVC was not evaluated in 34 other patients with liver abnormalities or unsatisfactory opacification of the intrahepatic IVC. In control subjects, narrowing was not observed in either the intrahepatic or suprahepatic IVC. Conclusion: Narrowing of the upper intrahepatic IVC can be seen in some patients with increased IAP. The cause and significance of this phenomenon remain to be determined.