A case report of thrombosed varicosities of pubic collateral veins: Ideal treatment strategy and contribution of era imaging technologies in diagnosis

Paramythiotis, Daniel; Goulas, Patroklos; Bangeas, Petros; Giannopoulos, Argirios; Kapoulas, Kostantinos; Rafailidis, Vasileios; Papadopoulos, Georgios; Ktenidis, Kiriakos; Kalogera‐Fountzila, Anna; Michalopoulos, Antonios

doi:10.1177/2050313x18757389

Cited by 3 publications

(5 citation statements)

References 11 publications

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“…5 Limitiations of these diagnostic imaging modalities include a high cost, low availability, and the need for iv contrast media. 2,3 May-Thurner syndrome, obstruction of venous return by compression of the left common iliac vein by the right common iliac artery, is an important differential diagnosis among patients with VPCV. It is usually present in the puerperium of young multipara women or associated with the use of oral contraceptives.…”

Section: Discussionmentioning

confidence: 99%

“…5 Limitiations of these diagnostic imaging modalities include a high cost, low availability, and the need for iv contrast media. 2,3…”

Section: Discussionmentioning

confidence: 99%

“…The most common cause is deep venous thrombosis of the lower limbs. 1,2 The workup of VPCV includes ultrasound, computed tomography and magnetic resonance imaging. This approach allows for a better understanding of the VPCV and facilitates ruling out secondary causes of deep vein occlusion.…”

Section: Introductionmentioning

confidence: 99%

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Suprapubic Varicose Veins Idiopathic: A Rare Presentation of Perineal Pelvic Retrograde Flow

Tuta-Quintero

Navarrete

Alfaro

et al. 2023

Vasc Endovascular Surg

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Background: Varicose pubic collateral veins are a rare phenomenon secondary to obstruction of the common femoral vein, left external iliac, or common iliac vein. This article aims to describe the clinical case of a 75-year-old female patient who presented with varicose collateral suprapubic veins. Case report: A 75-year-old female patient from a rural area in Colombia presented to the emergency department complaining of a 4-day history of edema, erythema, and pain in the suprapubic region. The patient presented with large varicose veins in the suprapubic region with erythema, warmth, and pain on palpation. A computer tomography scan of the abdomen and pelvis showed suprapubic varicose veins and contrasted in venous phase ruled out iliac vein obstruction. To rule out paraneoplastic syndrome, tumor markers, a transvaginal ultrasound, esophagogastroduodenoscopy and rectosigmoidoscopy were obtained and found to be negative. Anticoagulation with warfarin 5 mg daily and bridge therapy with enoxaparin was initiated. Conclusion: We presented the case of a patient with varicose collateral suprapubic veins of unknown origin, who received anticoagulation with warfarin and analgesic management with subsequent resolution of symptoms.

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Section: Discussionmentioning

confidence: 99%

“…5 Limitiations of these diagnostic imaging modalities include a high cost, low availability, and the need for iv contrast media. 2,3…”

Section: Discussionmentioning

confidence: 99%

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Suprapubic Varicose Veins Idiopathic: A Rare Presentation of Perineal Pelvic Retrograde Flow

Tuta-Quintero

Navarrete

Alfaro

et al. 2023

Vasc Endovascular Surg

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“…EIAE is defined as a specific intimal thickening of the wall of the artery. The precise pathophysiologic mechanism of EIAE is unclear [ 18 ]. EIAE is a rare disease seen primarily in young healthy endurance athletes.…”

Section: Discussionmentioning

confidence: 99%

An extremely rare disconnection of the external iliac artery and novel collateral remodeling in an endometrial stromal sarcoma woman

Wang

Zhou

et al. 2022

BMC Women's Health

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Background Injury to the external iliac artery can have serious consequences and can be extremely challenging for surgeons. Here, we report a patient with bizarre disconnection of the external iliac artery during a laparoscopic operation. Case presentation On May 27, 2020, during a laparoscopic pelvic lymphadenectomy operation to treat endometrial stromal sarcoma, we encountered an unusual anatomy: abnormal disconnection of the left external iliac artery in a 26-year-old female patient. The proximal and distal ends of the left external iliac artery demonstrated old narrowing without active bleeding, and the distance between the two disconnected ends was more than 3 cm. The scenario was surprising to all the staff in the operating theater. After a comprehensive assessment of skin temperature, arterial pulsation and arterial blood flow, a multidisciplinary team determined that collateral circulation of the left lower limb had been established and could meet the blood supply of the lower limbs, which was also confirmed three times by computed tomography angiography and Doppler ultrasound of the blood vessels in the abdomen and lower limbs. Sixteen months after the operation, the patient had no obvious abnormality, and the daily activities of the left lower limb were not affected. Follow-up after treatment for the patient is still in progress. Conclusions We describe the details of the whole case of disconnection of the external iliac artery. We hope to summarize the experience and lessons learned through this case and a relevant literature review to improve the safety and orderliness of our future clinical work.

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“…Наличие варикозного расширения вен на лобке и передней брюшной стенке (надлобковый шунт) традиционно рассматривается в качестве признака тромботической или нетромботической обструкции подвздошных вен [1][2][3][4]. Последняя может лежать в основе варикозной болезни таза с явлениями тазовой венозной недостаточности и (или) пельвиоперинеального рефлюкса [5].…”

Section: Introductionunclassified

Dilatation of suprapubic veins as a manifestation of pelvic varicose veins: description of a clinical case

Akulova,

Soroka,

Bondarchuk

et al. 2023

Ambulatornaya khirurgiya

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The presence of dilated suprapubic veins (suprapubic shunt) is considered to be a classic symptom of post-thrombotic and non-thrombotic venous outflow obstruction. Meanwhile, the descriptions of isolated cases of the creation of a suprapubic shunt during pregnancy in women with pelvic varicose disease are presented in the literature. We present a clinical case report of successful treatment of pelvic varicose disease with the presence of dilated veins in the suprapubic region. A 33-year-old patient complained of the presence of varicose veins in the lower extremities, in the perineum and suprapubic region, heaviness and pain in the lower extremities, a periodic heavy feeling and burning in the varicose vein area, painful menstruation and pain during intercourse. The symptoms appeared and progressed during four pregnancies, after the last one the patient noted the appearance of dilated veins in the suprapubic region. The ultrasound angiography of the lower extremity veins revealed valvular incompetence of the saphenofemoral junction and the trunks of the great saphenous vein bilaterally, the left anterior accessory saphenous vein, signs of pelvioperineal reflux, dilated veins of the perineum and round ligament of the uterus. The first stage surgery involved phlebography and embolization of the ovarian veins bilaterally. The patient showed positive response to treatment, which resulted in relief of dyspareunia and reduction of algodismenorrhea. The second stage surgery involved endovenous laser coagulation of the trunks of the great saphenous vein bilaterally and the left anterior accessory saphenous vein. Varicose vein tributaries on the lower extremities were removed by means of miniphlebectomy, while varicose veins of the perineum and suprapubic region were obliterated by foam sclerotherapy. Three months after the intervention, the patient had a stable obliteration of all target veins, clinical improvement, disappearance of dilated veins in the suprapubic region, regression of pain in the lower extremities and complete relief of dyspareunia and algodismenorrhea. Thus, the presence of varicose veins in the suprapubic region can be not only a consequence of venous obstruction, but also a symptom of pelvic varicose disease. If a suprapubic shunt is identified, a detailed examination of the patient, including imaging methods for evaluating abdominal or pelvic veins is required. The results of the tests will help develop an individual treatment plan.

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A case report of thrombosed varicosities of pubic collateral veins: Ideal treatment strategy and contribution of era imaging technologies in diagnosis

Cited by 3 publications

References 11 publications

Suprapubic Varicose Veins Idiopathic: A Rare Presentation of Perineal Pelvic Retrograde Flow

Suprapubic Varicose Veins Idiopathic: A Rare Presentation of Perineal Pelvic Retrograde Flow

An extremely rare disconnection of the external iliac artery and novel collateral remodeling in an endometrial stromal sarcoma woman

Dilatation of suprapubic veins as a manifestation of pelvic varicose veins: description of a clinical case

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