2021, Number 3
Endovascular treatment of pelvic varices secondary to the ''nutcracker'' phenomenon
Language: Spanish
References: 14
Page: 1-11
PDF size: 525.51 Kb.
ABSTRACT
Introduction: Pelvic congestion syndrome is a cause of recurrent consultation to the Gynecology services, given the variety of nosological entities that could cause the clinical condition; diagnosis and treatment often occurs late.Objective: To report the case of a patient with pelvic congestion syndrome associated with false nutcracker, treated endovascularly with satisfactory evolution.
Case report: We report the case of a 31-year-old female patient who came to the clinic with chronic pelvic pain associated with secondary symptoms such as increased flow in the left renal vein; endovascular treatment was chosen. Embolization of the pelvic varices was performed, and complete and immediate resolution of the clinical condition was obtained. Excellent evolution was observed at one year of follow-up.
Conclusions: The advancement of endovascular techniques has made it possible to develop embolization methods with or with no sclerosis of pelvic varices with very good immediate, medium and long-term results.
REFERENCES
Drazic BO, Zárate BC, Valdés EF, Mertens MR, Bergoeing RM, Krämer SA, et al. Dolor pélvico crónico secundario a síndrome de congestión pélvica. Resultados del tratamiento endovascular de la insuficiencia venosa pelviana y várices genitales. Rev Med Chil. 2019 [acceso 15/01/2021];147(1):41-6. Disponible en: https://scielo.conicyt.cl/pdf/rmc/v147n1/0717-6163-rmc-147-01-0041.pdf
Gómez Arbeláez D, Ansuátegui Vicente M, Comanges Yéboles A, Ibarra Sánchez G, Sánchez Guerrero Á, Villar Esnal R, et al . Síndrome de congestión pélvica: revisión actualizada de la literatura. Angiología. 2020 [acceso 10/01/2021];72(5):229-39. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0003-31702020000500003&lng=es
Motta Ramírez GA, Ruiz Castro E, Torres Hernández V, Herrera Avilés RA, Rodríguez Treviño C. El papel de la tomografia computada en la identificación del síndrome de congestión pélvica. Ginecol Obstet Mex. 2013 [acceso 19/01/2021];81:389-402. Disponible en: http://www.medigraphic.com/pdfs/ginobsmex/gom-2013/gom137.pdf
Hinojosa CA, Anaya Ayala JE, Boyer Duck E, Laparra Escareno H, Torres Machorro A, Lizola R. Hematuria macroscópica secundaria a síndrome de cascanueces y tratamiento endovascular exitoso. Cirugía y Cirujanos. 2017 [acceso 10/02/2021];85(1):19-25. Disponible en: https://www.sciencedirect.com/science/article/pii/S0009741116301360
Farina R, Iannace FA, Foti PV, Conti A, Inì C, Libra F, et al. A Case of Nutcracker Syndrome Combined with Wilkie Syndrome with Unusual Clinical Presentation. Am J Case Rep. 2020 Apr [acceso 15/01/2021];21:e922715. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193224/pdf/amjcaserep-21-e922715.pdf
Heidbreder R. Co-occurring superior mesenteric artery syndrome and nutcracker syndrome requiring Roux-en-Y duodenojejunostomy and left renal vein transposition: a case report and review of the literature. J Med Case Rep. 2018 Aug [acceso 15/01/2021];12(1):214. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6091179/pdf/13256_2018_Article_1743.pdf
Reyes Ortega JP, Robles Martín MA, Rodríguez Morata A. Tratamiento endovascular de la insufuciencia venosa pélvica primaria: Varicocele masculino y várices periuterinas. En Guerra Requema M, Rodríguez Morata A. Tratamiento endovascular de la patología venosa. 1 ed. España: AACHE; 2018 p.175-84. [acceso 10/02/2021]. Disponible en: https://cirugiaendovascular.com/cirugiaendovascular/Tratamiento-endovascular-CCEV-2018.pdf