Double Inferior Vena Cava Diagnosed Following Urinalysis Screening in a 15-Year-Old Boy

Microscopic hematuria is one of the most common findings in urinalysis screening. While some cases may be clinically significant, such as early-stage glomerulonephritis, the majority are of limited clinical significance, including asymptomatic hematuria. We report a case where microscopic hematuria was first detected at age 3 and became more pronounced at age 15, leading to further evaluation. Imaging studies revealed a rare congenital vascular anomaly, double inferior vena cava, with narrowing at the junction of the left renal vein and the inferior vena cava. This narrowing caused mild elevation in renal vein pressure, likely contributing to the observed microscopic hematuria. Repeated positive findings in urinalysis screening provided the opportunity for further investigation, leading to diagnosis. This highlights the importance of considering vascular anomalies in cases of unexplained microscopic hematuria. Comprehensive evaluation, including imaging, can be essential in identifying the underlying cause and guiding management in such patients.