Pelvic congestion syndrome

Case contributed by Juan José Maya González

Presentation

Pelvic pain

Patient Data

Age: 50 years
Gender: Female
CT

Bilateral periuterine varicose veins, more prominent and tortuous on the left side. Left ovarian vein increased in caliber reaching a maxium diameter of 9-10 mm. Findings compatible with pelvic congestion syndrome (grade II).

Circumaortic left renal vein. 

Anterior nutcracker syndrome with decrease in distance and angle between the proximal part of the superior mesenteric artery and the aorta (aortomesenteric clamp). This generates compression of the left renal vein.

Also there is a bit of compression of the posterior branch of the circumaortic left renal vein between the aorta and the vertebral body of L4 (posterior nutcracker syndrome).

Abnormal orientation of IUCD, perpendicular to the endometrial cavity and horizontal tube to tube.

Case Discussion

Pelvic congestion syndrome associated with both left circumaortic renal vein and nutcracker syndrome (predominantly duer to aortomesenteric clap). 

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