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CC BY 4.0 · European J Pediatr Surg Rep. 2021; 09(01): e56-e60
DOI: 10.1055/s-0041-1730998
Case Report

Pelvic Venous Congestion Secondary to a Circumaortic Renal Collar in an Adolescent Female: Report of a Case

Verónica Alonso-Arroyo 
1   Department of Pediatric Surgery, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
,
Jose Javier Velasco
2   Department of Interventional Radiology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
,
Sonia Pérez-Bertólez 
3   Department of Pediatric Urology, Hospital Sant Joan de Deu, Barcelona, Catalunya, Spain
,
Maria Elena Molina
1   Department of Pediatric Surgery, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
,
Jose Manuel Marugan-de-Miguelsanz
4   Department of Pediatric Gastroenterology, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
,
Alberto Sanchez-Abuin
1   Department of Pediatric Surgery, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
,
Oscar Dario Gomez Beltran
1   Department of Pediatric Surgery, Hospital Clinico Universitario de Valladolid, Valladolid, Castilla y León, Spain
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Abstract

We report a 13-year-old girl who presented with a recurrent abdominal pain that started after her menarche. The abdominal palpation revealed tenderness over the left ovarian point. The laboratory study, ultrasonography, and abdominal X-ray were normal. The computed tomography and magnetic resonance imaging showed a double left renal vein with a retroaortic component, an increased left parauterine circulation, and ipsilateral ovarian vein engorgement. A diagnostic and therapeutic phlebography allowed a selective catheterization of a group of pelvic varicose veins draining to the left ovarian and to the internal iliac veins. There were no complications during the procedure and the symptoms disappeared 2 days later. Circumaortic left renal vein may cause hematuria, proteinuria, pelvic congestion syndrome, and massive hemorrhage during surgery. A conservative treatment is recommended for patients without gynecourological/renal symptoms or with mild hematuria. The endovascular treatment by gonadal venous embolization is safe and effective.

Keywords

renal vein - pelvic pain - embolization - phlebographie


Publication History

Received: 16 May 2020

Accepted: 01 May 2021

Article published online:
10 August 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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