Azygous Continuation of the Inferior Vena Cava: Potential Misdiagnosis as Liver Cirrhosis

Azygos continuation of the inferior vena cava (ACIVC) is a rare congenital anomaly characterized by the absence of the intrahepatic segment of the inferior vena cava. Although typically benign and incidental, it can mimic other pathologies on imaging. We present a case of ACIVC in a 37-year-old man, initially misdiagnosed as portal hypertension with mediastinal varices and possible liver cirrhosis, with the diagnosis ultimately confirmed by CT angiography demonstrating ACIVC. This report highlights the diagnostic challenges of ACIVC and underscores the importance of correlating imaging findings with the clinical picture for accurate diagnosis.