Tehran University of Medical Sciences Frontiers in Emergency Medicine 2717-3593 6 2 2021 11 14 e27 e27 EN Moloud Balafar Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran Zahra Parsian Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran Reza Javad Rashid Department of Radiology, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran Navid Elmdust Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran Houri Arjmandi Emergency Medicine Department, Qazvin University of Medical Sciences, Qazvin, Iran Hassan Soleimanpour Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2021 09 12 2021 09 15 A 47-year-old female with a history of antiphospholipid syndrome and ischemic stroke was presented to the emergency department due to abdominal pain and bloody vomiting. Ultrasonography showed double inferior vena cava and bilateral mild hydronephrosis. Furthermore, the abdominal computed tomography (CT) scan did not show any evidence of urolithiasis. The ultrasound images of distinctive developmental variations of inferior vena cava and other veins are important to be known. Vascular anomalies, although rare, should be taken into account in the differential diagnosis of focal lesions within the abdominal cavity. Double IVC might have been the cause of hydronephrosis in our patient. https://fem.tums.ac.ir/index.php/fem/article/view/855 https://fem.tums.ac.ir/index.php/fem/article/download/855/379