Learning objectives
To recognize how important and easy is to perform ultrasound plus Doppler-Color in the Pelvic Congestion Syndrome.
To show the typical sonographic signs of thePelvic Congestion Syndrome identifying the intra-pelvic venous patterns.
Background
Chronic pelvic pain affects about ten million women in the world,
of which 70% remain without etiological diagnosis and therefore without adequate treatment despite technological advances,
becoming a relevant problem in the fertile age,
that becomes 10% of the external consultation of specialties such as gynecology.1Whiteley et al.
published: "It has previously been shown to be present in one in five women who present with leg varicose veins and have had previous vaginal deliveries"2
For the joint analysis of the Pelvic Congestion Syndrome(PCS),
the first...
Findings and procedure details
PELVIC CONGESTION SYNDROME
The criteria for establishing the ultrasonographic diagnosis of SCP include1-3:
Urethral and ovarian plexuses and / or tortuous pelvic veins with a diameter> 6 mm.
Slow flow (<3 cm / s) or reversal of flow in ovarian veins.
Dilated myometrial arcuate veins that communicate with varicose pelvic veins.
Reflux and dilatation of the venous trunks on Valsalva,
reflux must be >1 s within the venous trunks and persist until the end of the manoeuvre.
Any associated varices should show flow reversal and...
Conclusion
In the presence of non-saphenous reflux,
mainly buttocks or genitalia,
perform abdominal Doppler to assess the ilio-cavo axis and aortomesenteric compas.
Rate speeds,
taking into account the angulation of the vessel to less than 60 ° and the sample volume.
If a gradient greater than 5 is visualized,
associated or not with a monophasic vascular signal,
report as signs of extrinsic compression.
The pelvic Doppler TV standing is more specific to determine the venous caliber (greater than 6mm)
The PCS represents a diagnostic challenge,
so...
Personal information
Diagnostic imaging.
HospitalMilitar Central.
Buenos Aires.Argentina.
Belen Campagno MD
Diagnostic imaging.
HospitalFernández.
Buenos Aires.Argentina.
Sebastián Rivadeneira MD
Contact email:
[email protected]
References
Marsh P,
Holdstock J,
Harrison C,
et al.
Pelvic vein reflux in female patients with varicose veins: comparison of incidence between a specialist private vein clinic and the vascular department of a National Health Service District General Hospital.
Phlebology 2009; 24: 108–113.
Whiteley M,
Dos Santos S,
Harrison C,
Holdstock J,
Lopez A.
Transvaginal duplex ultrasonography appears to be the gold standard investigation for the haemodynamic evaluation of pelvic venous reflux in the ovarian and internal iliac veins in women.Phlebology.2014:Epub ahead of print
Malgor RD,...