Unusual Presentation of Nutcracker Syndrome in Patient With Prior Gonadal Vein Embolization for Pelvic Congestion Syndrome

2016 ◽  
Vol 4 (1) ◽  
pp. 148
Author(s):  
T.L. Weis Sadoski ◽  
A. Bunnell ◽  
J. Robison ◽  
J. Adams
Keyword(s):  
Unusual Presentation ◽  
Nutcracker Syndrome ◽  
Pelvic Congestion Syndrome ◽  
Gonadal Vein ◽  
Pelvic Congestion

Using magnetic resonance phase-contrast velocity mapping for diagnosing pelvic congestion syndrome

2011 ◽  
Vol 26 (4) ◽  
pp. 157-161 ◽  
Author(s):  
L Q Meneses ◽  
S Uribe ◽  
C Tejos ◽  
M E Andía ◽  
M Fava ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Phase Contrast ◽  
Clinical Suspicion ◽  
The Other ◽  
Invasive Procedures ◽  
Velocity Mapping ◽  
Pelvic Congestion Syndrome ◽  
Gonadal Vein ◽  
Diagnostic Criterion ◽  
Pelvic Congestion

Objective To evaluate phase-contrast velocity mapping (PCVM) as a diagnostic tool for pelvic congestion syndrome and comparing this approach with direct venography. Method We prospectively include nine women with clinical suspicion of pelvic congestion syndrome during a six-month period. All patients underwent a magnetic resonance phase-contrast scan before a direct venography. We considered a case of pelvic congestion syndrome when the PCVM showed a retrograde or slow (less than 5 cm/second) flow in any gonadal vein. This criterion was compared with the standard diagnostic criterion observed from a direct venography. Results Using direct venography we found 14 abnormal veins and all of them were correctly identified by the PCVM. The other four veins were found to be normal by the direct venography. However, two of them (the same patient) were abnormal in the PCVM, even though this patient had the classical symptoms of pelvic congestion syndrome. Conclusion PCVM is a useful tool for diagnosing pelvic contrast syndrome and can avoid invasive procedures such as direct venography.

scholarly journals Aortomegaly Causing Nutcracker Syndrome and Pelvic Congestion Syndrome

2018 ◽  
Vol 02 (03) ◽  
pp. 197-200
Author(s):  
Krantikumar Rathod ◽  
Amit Sahu ◽  
Bhavesh Popat ◽  
Hemant Deshmukh
Keyword(s):  
Renal Function ◽  
Renal Vein ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Ovarian Vein ◽  
Endovascular Management ◽  
Management Options ◽  
Pelvic Congestion Syndrome ◽  
Pelvic Varices ◽  
Pelvic Congestion

AbstractThe authors present an uncommon cause of pelvic congestion syndrome (PCS) secondary to anterior nutcracker syndrome, which was caused by aortomegaly. Positional flank and pelvic pain was the only presenting feature with no renal dysfunction. Early and significant decompression of left renal vein (LRV) via left ovarian vein resulted in preserved renal function with symptomatic pelvic varices. Endovascular management by left ovarian vein coiling and LRV stenting was done. They briefly review the etiopathology, imaging, treatment rationale, and management options for nutcracker and PCS.

scholarly journals Role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Ahmed A. Baz
Keyword(s):  
Left Renal Vein ◽  
Duplex Ultrasound ◽  
Iliac Vein ◽  
Round Ligament ◽  
Common Iliac Vein ◽  
Pelvic Congestion Syndrome ◽  
Gonadal Vein ◽  
Mean Diameter ◽  
Pelvic Congestion

Abstract Background For evaluation the role of trans-abdominal and trans-perineal venous duplex ultrasound in cases of pelvic congestion syndrome, fifty patients with pelvic congestion syndrome were included in the current research. All were evaluated by trans-abdominal and trans-perineal venous duplex. Results An incompetent left gonadal vein was detected in all cases with a mean diameter (± SD) = 7.9 ± 1.1 mm. The right gonadal vein was incompetent in 4 cases (8%) with a mean diameter (± SD) 5.9 ± 0.4 mm. A refluxing proximal internal iliac vein was detected in 3cases (6%). Left renal vein nutcracker was present in 41cases (82%) while the left common iliac vein compression was present in 3 cases (6%). Vulvoperineal varicosities were seen in all cases {right side = (36%, n = 18), left side = (30%, n = 15), and bilateral = (34%, n = 17)}.Thigh extension of the vulvoperineal varicosities was present in (74%, n = 37). Round ligament varicosities were present in (6%, n = 3). Conclusions Trans-abdominal and trans-perineal venous duplex offer a simple, noninvasive, and quick technique that can help in an accurate evaluation of the ovarian vein reflux, diameters as well as the presence of vulvoperineal, and round ligament varicosities, Moreover, it is useful in the assessment of the left renal and iliac veins compression.

Transperitoneal Laparoscopic Left Gonadal Vein Ligation Can Be the Right Treatment Option for Pelvic Congestion Symptoms Secondary to Nutcracker Syndrome

Vascular ◽  
2007 ◽  
Vol 15 (4) ◽  
pp. 238-240 ◽  
Author(s):  
Alistair Rogers ◽  
Andrew Beech ◽  
Bruce Braithwaite
Keyword(s):  
Mesenteric Artery ◽  
Left Renal Vein ◽  
Nutcracker Syndrome ◽  
Venous Flow ◽  
Nutcracker Phenomenon ◽  
Gonadal Vein ◽  
Multiparous Women ◽  
The Right ◽  
Laparoscopic Sterilization ◽  
Pelvic Congestion

The nutcracker phenomenon refers to compression of the left renal vein at the origin of the superior mesenteric artery and is often underdiagnosed. This can cause symptoms of pelvic venous congestion with retrograde venous flow and a dilated gonadal vein. Here we describe a case in a 39-year-old female, who following imaging investigations to confirm the diagnosis, underwent transperitoneal laparoscopic ligation of the left gonadal vein. Laparoscopic sterilization was also performed with the aid of the gynecologists. Multiparous women, who are more likely to develop pelvic congestion symptoms, more commonly request sterilization and thus we propose that a dual laparoscopic procedure in these cases could be the treatment of choice.

scholarly journals Atypical presentations and treatment variations of pelvic congestion syndrome: A four patient case series

F1000Research ◽  
2016 ◽  
Vol 5 ◽  
pp. 2906
Author(s):  
David Greuner ◽  
Andrew Amorosso ◽  
Arno Rotgans ◽  
Chris Hollingsworth ◽  
Adam Tonis
Keyword(s):  
Case Series ◽  
Duplex Ultrasound ◽  
Chronic Lower Back Pain ◽  
Case Review ◽  
Retrospective Case ◽  
Pelvic Congestion Syndrome ◽  
Atypical Symptoms ◽  
Gonadal Vein ◽  
Atypical Presentations ◽  
Pelvic Congestion

This is a retrospective case review of four patients randomly selected from a pool of 43 patients who presented to our practice with historically atypical symptoms for pelvic congestion syndrome, and the treatment they received. These 43 patients were treated between June and December of 2016. Each patient presented with various atypical symptoms including chronic lower back pain, urinary frequency and incontinence, hip pain, tenesmus, and uncontrollable flatulence. Diagnostic abdominal and pelvic duplex ultrasound and fluoroscopic venography was performed on all patients with informed consent. The four selected patients for this study were all positive for pelvic venous reflux, pelvic venous insufficiency and ovarian/gonadal vein reflux and varicosities. All four of the patients selected in this retrospective study were examined at 1 week from date of intervention and again at 1 month from date of intervention. At the 1 week postoperative exam all four patients had experienced significant resolution of their symptoms, although all had residual congestion present on their right side. After re-intervention to treat right sided congestion via the right gonadal vein, at the 1 month postoperative exam all four patients had experienced an almost complete resolution of symptoms.

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