Surgical treatment of pelvic varicose veins and aorto-mesenteric compression in a 15-year-old girl



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Introduction. The pelvic congestion syndrome accounts for up to 4% of all causes of chronic pelvic pain in adolescent girls and infrequently may be associated with the obstruction of venous outflow due to compression of the left renal vein resulting in venous hypertension.

Case report. A clinical case of surgical treatment of a 15-year-old female patient with the pelvic congestion syndrome and nutcracker syndrome is described. The diagnosis was confirmed by MRI, phlebography with phlebotonometry of the left renal vein and pelvic ultrasound with Valsalva maneuver performed with an empty bladder. Disease symptoms were manifested by chronic pelvic pain and dysmenorrhea. The authors made a gonadoileal bypass with the formation of an end-to-side anastomosis to achieve the most physiological discharge of blood through the gonadal vein and to exclude the formation of stenosis in the anastomosis.

Results. 3 months after the surgical treatment, the created gonadoileal bypass functioned well with 30 cm/s blood flow velocity without signs of stenosis and reflux in the ovarian vein.

Conclusion. The end-to-side gonadoileal anastomosis is a reasonable curative option in children with the pelvic congestion syndrome and nutcracker syndrome as it has been demonstrated with satisfactory results of shunt functioning at the early and late postoperative periods and an adequate decrease of renal venous hypertension. A multidisciplinary approach is important in the management of pediatric and adolescent patients with chronic pelvic pain and pelvic congestion syndrome for early detection of pathology and its surgical treatment to exclude progression of the disease in adulthood.

作者简介

Yu. Polyaev

Russian Children’s Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-9554-6414

119571 Moscow, Russian Federation

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R. Garbuzov

Russian Children’s Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0002-5287-7889

119571 Moscow, Russian Federation

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A. Turchinets

Pirogov Russian National Research Medical University

编辑信件的主要联系方式.
Email: ponomarevaanna28@gmail.com
ORCID iD: 0000-0002-4478-9133

Anna I. Turchinets – resident of the department of obstetrics and gynecology

117997 Moscow, Russian Federation

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I. Karachentsova

Russian Children’s Clinical Hospital; Pirogov Russian National Research Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0002-0254-690X

119571 Moscow, Russian Federation

117997 Moscow, Russian Federation

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M. Sukhov

Russian Children’s Clinical Hospital

Email: fake@neicon.ru
ORCID iD: 0000-0003-4412-3056

119571 Moscow, Russian Federation

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