China
Africa
Explore chapters and articles related to this topic
Practical guide for pelvic insufficiency scanning
Published in Joseph A. Zygmunt, Venous Ultrasound, 2020
While these disorders can be in either the male or female patient, it is a predominantly female disease process due to the hemodynamic and hormonal changes to the female pelvis during pregnancy. During pregnancy blood flow to the female pelvis increases by 60%, and due to estrogen levels venodilation occurs resulting in the formation of pelvic varices [1,2,5]. In this chapter, topics will be discussed from a female anatomic prospective; however, the same examination technique can be applied to the male patient, substituting evaluation of the ovarian veins with the gonadal veins and eliminating the evaluation of pelvic varices. Clinically, female pelvic symptoms can be quite complex and do not always have a clear origin; thus, gynecological involvement is important to rule out solid organ pathology and gives a well-rounded team approach to the treatment of the patient's symptoms.
Kidneys and ureters
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The kidneys are surrounded by a distinct, well-defined envelope of perinephric fat. Nephrectomy is facilitated by staying at the true margin of the perinephric fat envelope. The perinephric fat is ‘whiter’ than colonic mesenteric fat as observed during a laparoscopic nephrectomy. At the renal hilum, the first structure encountered (i.e. the uppermost) is the renal vein, then the renal artery and lastly the renal pelvis. The right renal vein is much shorter than the left renal vein. The left renal vein is occasionally retroaortic. The right adrenal vein and right gonadal vein drain into the inferior vena cava (IVC) whereas the left adrenal and gonadal veins drain into the left renal vein. Gonadal veins can easily be confused for ureters - these structures are distinguished by pinching the ureter which contracts (vermiculation).
Venous compression syndromes
Published in Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland, Manual of Venous and Lymphatic Diseases, 2017
Ken Myers, Paul Hannah, Marcus Cremonese, Lourens Bester, Phil Bekhor, Attilio Cavezzi, Marianne de Maeseneer, Greg Goodman, David Jenkins, Herman Lee, Adrian Lim, David Mitchell, Nick Morrison, Andrew Nicolaides, Hugo Partsch, Tony Penington, Neil Piller, Stefania Roberts, Greg Seeley, Paul Thibault, Steve Yelland
Conservative treatment is recommended for mild haematuria, particularly in young patients. If intervention is warranted, then the objective is to reduce outflow obstruction. Stenting of the renal vein should be considered first. Reported complications of stenting include stent migration, thrombosis and late stent stenosis. Anticoagulation is recommended. This may be followed by embolization of the left gonadal vein, provided it can be shown that it is not an outflow conduit.
Comprehensive overview of the venous disorder known as pelvic congestion syndrome
Published in Annals of Medicine, 2022
Kamil Bałabuszek, Michał Toborek, Radosław Pietura
Left renal vein stenting in the management of the NCS has shown some efficacy in the treatment of PCS caused by this syndrome. However, there are few studies with small numbers of participants [118,119]. Stenting of the left renal vein is associated with a high risk of migration to the vena cava and the heart due to short vein length and change in vein diameter when the patient changes position or performs the Valsalva manoeuvre [120]. Left renal vein transposition is not always successful and it is correlated with serious complications like bleeding, thrombosis, kidney injury or infection [42,118]. In 2020 Gilmore et al. reported gonadal vein transposition in 18 patients, with complete symptom relief in 11 patients (61.1%) after a median follow-up of 178 days [121]. Complications of percutaneous embolisation are usually rare and harmless. These include recurrence of symptoms, haematoma at the puncture site, allergic reaction, embolic agent migration or coil erosion [78,122,123].
Isolated ovarian vein thrombosis in COVID-19 infection
Published in Baylor University Medical Center Proceedings, 2021
Udhayvir Singh Grewal, Sreecharan Mavuram, Nancy Bai, Poornima Ramadas
Five days after discharge, she developed severe right-sided throbbing abdominal pain. Computed tomography (CT) of the abdomen and pelvis showed right-sided partial OVT (Figure 1). Ovarian Doppler ultrasound showed normal flow. She was a nonsmoker with no prior history of thromboembolism, even during seven previous pregnancies. Testing was normal for antiphospholipid antibodies with lupus anticoagulant, protein C, protein S, and antithrombin III levels. Factor V Leiden and prothrombin gene mutation tests were negative. Testing for JAK2 V617 mutation, JAK2 exon 12 mutation, and flow cytometry for paroxysmal nocturnal hemoglobinuria were also unremarkable. The patient’s unprovoked isolated gonadal vein thrombosis was assumed to have resulted from COVID-19–associated coagulopathy.
Surgical aspects of venous pelvic pain treatment
Published in Current Medical Research and Opinion, 2019
S. G. Gavrilov, O. I. Efremova
Venous outflow from the pelvic organs occurs via the system of internal iliac and gonadal veins. Gonadal veins carry blood from the ovaries, and the left gonadal vein drains into the left renal vein, while the right one joins the inferior vena cava below the ostium of the right renal vein. Internal iliac veins are paired vessels with valvular apparatus that have visceral and parietal tributaries. Visceral tributaries are represented by uterine, bladder, upper, middle and lower rectal veins draining the same-named venous plexuses. In addition, there is a vaginal venous plexus, which has a direct connection with the veins of the uterus and external genital organs. Vein dilation and blood reflux in the gonadal veins and tributaries of the internal iliac veins result in blood stagnation in the intrapelvic venous plexus and the development of PCS.