Purpose or Case Report: The ductus venosus is a part of the fetal circulation that permits oxygenated blood in the umbilical vein to bypass the liver and provide oxygenated blood to the fetal brain and heart. Absence of the ductus venosus is a rare anomaly associated with a number of serious, life-threatening and often deadly conditions. Studies have evaluated the use of ultrasound for prenatal evaluation and detection of absent ductus venosus; however, no studies have reported non-ultrasound postnatal radiological findings of absent ductus venosus. Here, we describe the expected anatomy in those with absent ductus venosus and present abdominal x-rays of 3 infants to illustrate an expected but abnormal course of umbilical venous lines in these patients. As many as 15.6% of patients with absent ductus venosus have it in isolation and with 67-100% postnatal survival when occurring in isolation. Thus, the postnatal incidental identification of absent ductus venosus is a clinical possibility for pediatric radiologists that review abdominal x-rays to check catheter/line placement. Familiarity with this abnormal course of umbilical venous lines may assist in making this rare postnatal diagnosis and avoid potentially life-threatening complications secondary to line malposition/repositioning.
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