Azygos ladder and looped thoracic duct – a case report

Knowledge of variations in the posterior mediastinum close to the vertebral column is important for cardiothoracic surgeons, radiologists and orthopedic surgeons. We report variations of azygos veins and thoracic duct. The azygos system of veins showed a ladder pattern. The hemiazygos and accessory hemiazygos veins communicated with the azygos vein through six transverse channels across the vertebral column. The accessory hemiazygos and hemiazygos veins joined to form a common channel which opened into the azygos vein. The thoracic duct gave two branches in the posterior mediastinum and these branches joined to form a loop.