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Endometriosis of the Pelvic Nerves
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Shaheen Khazali, Marc Possover
An incision is made just lateral to the external iliac artery into the iliolumbar space, to expose the psoas major muscle and the external iliac vessels. The external iliac artery and vein are then carefully deflected medially, using gradual and slow dissection. Care must be taken to avoid excessive traction on the large vessels. The external iliac vein, in particular, can be traumatized at this stage. See Figure 13.3.
Practice exam 4: Questions
Published in Euan Kevelighan, Jeremy Gasson, Makiya Ashraf, Get Through MRCOG Part 2: Short Answer Questions, 2020
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf
A 34-year-old, primigravid woman, with a body mass index (BMI) of 25 kg/m2 and no other medical problems, presents at 30 weeks’ gestation with a painful left leg. It is swollen and slightly mottled in appearance. What will be the initial management? (6 marks)The diagnosis is subsequently confirmed to be a venous thromboembolism (VTE) occluding the left external iliac vein. Discuss her antenatal management. (6 marks)How should her labour and postpartum period be managed? (8 marks)
Venous anatomy
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
At a basic level, the common femoral vein becomes the external iliac vein after crossing the inguinal ligament, and dives posteriorly into the pelvis. The external iliac vein joins the internal iliac vein, forming the common iliac vein [17].
Retroperitoneal liposarcoma in older person – a rare case report
Published in The Aging Male, 2020
Navas Nadukkandiyil, Sameer Valappil, Marwan Ramadan, Essa Al Sulaiti, Hanadi Khamis Alhamad
We report here a case of primary dedifferentiated liposarcoma in the retroperitoneum. A 77-year-old elderly gentleman was presented to our outpatient clinic with chief complaints of urinary incontinence for the last four years, weight loss >10 kg since 1 year, loss of appetite, tiredness and chronic constipation. On examination he had a mass in the right iliac fossa, measuring around 8 cm × 5 cm, hard in consistency, immobile and non-pulsatile on evaluation. He had microcytic hypochromic anemia and renal impairment with negative stool occult blood with all other basic investigation normal. Abdominal ultrasonography showed Ill-defined solid mass like area with vascularity are right lower quadrant measuring 11.4 × 11.5 cm. We proceeded with CT abdomen with contrast, which showed a large lower abdominal and pelvic retroperitoneal mass lesion occupying the midline and right lower abdomen measuring approximately 13 × 15 × 12.5 cm. The mass demonstrates inhomogeneous enhancement with a few small areas of necrosis. No calcification or definite fat component identified. The mass was encasing the right common iliac, external and internal iliac vessels with marked narrowing of the right common iliac and proximal external iliac vein. A short segment of a partially thrombosed right common iliac artery noted with atheromatous aortic calcification. Right pelvic ureter was displaced anteriorly and is markedly compressed at the level of the lesion with upstream moderate hydroureteronephrosis.
Behçet’s disease; A rare refractory patient with vena cava superior syndrome treated with infliximab: a case report and review of the literature
Published in Acta Clinica Belgica, 2019
Oguz Abdullah Uyaroglu, Abdulsamet Erden, Levent Kilic, Bora Peynircioğlu, Omer Karadag, Umut Kalyoncu
In our case, the patient had thrombus in inferior vena cava and iliac veins and he was currently using warfarin when he was admitted to us. We detected bilateral internal iliac artery aneurysms and thrombus in vena cava inferior that extends to common iliac veins and external iliac veins, simultaneously. In this time, we decided to implant bilateral stent-graft to the iliac aneurysms. Patient was anticoagulated with warfarin and a shunt was implanted between left brachiocephalic vein and right atrium. We continued therapy with warfarin. After the IFX therapy, we have not detected any thrombus or occlusion again. However, we do not know whether this is due to anticoagulation or infliximab therapy. It is believed that venous disease in BD results from endothelial inflammation [24]. Therefore, to control systemic inflammation is very important. Seyahi et al. reports their approach is to not anticoagulate BD patients with venous thrombosis, instead treating these patients with immunosuppressive agents alone. Therewithal treatment of thrombosis in BD differs between clinics [1].
Faecal impaction causing bilateral pelvic venous thrombosis
Published in Acta Chirurgica Belgica, 2018
Maxime Dewulf, Yves Blomme, Cedric Coucke
In only one of the above, unilateral venous compression had led to a deep venous thrombosis (DVT) of the external iliac vein on the left side. Recent prospective data from asymptomatic patients with a CT-graphic diagnosis of iliac vein compression syndrome (IVCS), or Cockett’s syndrome, indeed show a low incidence of DVT [7]. In only 6 of the 500 included patients (with compression of the iliac vein) a DVT occurred during a follow-up of 12 months. A compression of the iliac vein of more than 50% appeared to be the only independent risk factor significantly increasing the risk of DVT. This is probably why a bilateral DVT of the iliac vein complicating venous compression by faecaloma is rare, and remained unreported so far.