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CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2021; 31(03): 539-544
DOI: 10.1055/s-0041-1735497
Original Article

Pelvic Congestion Syndrome: A Missed Opportunity

Claire Kaufman 
1   Department of Radiology, University of Utah, Salt Lake City, Utah, United States
,
Nancy Ann Little
2   Department of Radiology, University of Wisconsin, Madison, Wisconsin, United States
› Author Affiliations Funding None.
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Abstract

Background/Aims Chronic pelvic pain (CPP) is pelvic pain for greater than 6 months with many potential causes one being pelvic congestion syndrome (PCS). PCS is diagnosed by clinical symptoms, exclusion of other etiologies, and imaging. Given the complex nature and diagnosis of CPP, we examined ordering and referral patterns in our local population to understand how the imaging findings of PCS correlate with patient symptoms and referral and treatment.

Materials and Methods After IRB approval, we searched all 18 to 70-year-old females with CT of the pelvis between March 2015 and March 2018 with the terms “pelvic” plus “congestion,” “varices,” or “vein dilation” in the dictation. Via electronic medical record and image review we collected data regarding demographics, clinical presentation, symptoms, imaging findings, ordering provider, and any follow-up/referrals or interventions regarding PCS.

Results A total of 96 patients were included of the 197 studies, with an average age of 47 years and average body mass index of 19.3 (n = 93) at the time of imaging. The reason for imaging was often acute abdominal or flank pain (n = 22) with 38% of cases ordered from the emergency room. Only 72 patients had documentation of clinical evaluation for symptoms of PCS. Notably, only 20 were referred for their symptoms, and only two patients were referred to IR. Both patients underwent successful endovascular intervention.

Conclusion CPP is a common cause of morbidity with PCS representing an underdiagnosed cause. We demonstrate that while imaging findings may be incidental, we are failing to capture and triage patients with clinical symptoms of PCS. Radiologists can play a key role in the care of these patients.

Keywords

pelvic venous insufficiency - pelvic congestion syndrome - chronic pelvic pain - embolization

Note

This study was presented at the Society of Interventional Radiology 2019 Annual Meeting as a poster.




Publication History

Article published online:
07 September 2021

© 2021. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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