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Left-sided inferior vena cava (IVC) was identified preoperatively in the case of abdominal aortic aneurysm. At operation, the left-sided IVC and bilateral common iliac veins were severely pressed by the huge aneurysm, and the walls of these vessels were thin and fragile at the site adhered to the aneurysm. Careful dissection around the common iliac arteries resulted in a successful operation. Without an awareness of such anomaly, accidental injury of IVC and the common iliac veins may occur. Preoperative diagnosis and accurate information from echography, CT scan, and venography of the vena cava are recommended in such rare cases.
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