Chronic Occlusion of the Superior Vena Cava- On physical examination, marked venous dilatation was apparent on the abdomen (Panel A). Computed tomographic (CT) angiography revealed collateral circulation through anastomoses between the subcutaneous veins and the common femoral veins, particularly on the right side (Panel B). The superior vena cava was occluded in its distal portion, as seen in a CT scan (Panel C, arrow), and the azygos vein was obstructed at the level of the carina. The inferior vena cava was patent. #clinical #photo #radiology #CT #vena #cava #occlusion #NEJM