Presentation
Pelvic pain.
Patient Data
Age: 65 years
Gender: Female
From the case:
Nutcracker phenomenon with pelvic congestion syndrome
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Bilateral calyceal microlithiasis, at least two on the right and one on the left with right renal scarring (incidental findings).
Compression of the left renal vein between the superior mesenteric artery (SMA) and aorta, in keeping with Nutcracker phenomenon.
Dilated left ovarian vein with multiple bilateral venous varicosities around and within the uterine wall in keeping with pelvic congestion syndrome.
Case Discussion
Pelvic congestion syndrome is considered the female homologue to testicular varicocele. It may be caused by:
venous obstruction: such as retroaortic left renal vein
or compression of the left renal vein by SMA also known as nutcracker phenomenon (as in this case)
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