Pelvic Congestion Syndrome with Reflux in the Left Ovarian Vein

Clinical details

Unexplained pelvic disorders. The pelvic CT findings were incorrectly diagnosed as an angioma.

Summary findings

Aplasia of the infrarenal vena cava. Differential diagnosis: old thrombotic plug. Reflux into the left ovarian vein is not uncommon and normally clinically asymptomatic. Caused by the ‘nutcracker phenomenon’ with compression of the left renal vein between the dorsal aorta and ventral upper mesenteric vein.

Diagnosis

Compression of the left renal vein.

Description of images

[1 – 2] Steady-state after Gadofosveset i.v.. Reflux of contrast blood from the left renal vein into the left ovarian vein causing reversed flow and secondary enlargement (arrow = direction of flow). ->

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