Radiologic findings of pelvic venous congestion in an adolescent girl with angiographic confirmation and interventional treatment

Carolyn Wassong, Bina Shah, Masahide Kanayama, Haraldur Bjarnason, Sarah S Milla
Pediatric radiology · 2012 · doi:10.1007/s00247-011-2232-y · PMID:21912968
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⚙ AI-generated summary by claude@2026-06, 2026-06-13 ⓘ

This case report details the radiologic findings and interventional treatment of pelvic venous congestion and endometriosis in an adolescent girl, highlighting the condition's presence in children.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-13 · read from full text ⓘ

This paper reports a single case of pelvic venous congestion in a 13-year-old girl with 9 months of pelvic pain, where pelvic congestion syndrome was suggested by sonography, CT, and MRI with classically described imaging findings. Diagnostic laparoscopy showed congested pelvic veins and endometriosis; after endometrial implant removal, her pain persisted, leading to venography with ovarian vein embolization. The authors emphasize that they found no prior literature describing pelvic venous congestion in children, highlighting a knowledge gap for pediatric radiologists. Relevance to endometriosis: the case explicitly involved endometriosis found at laparoscopy alongside pelvic venous congestion, though the paper primarily documents pediatric radiologic findings and interventional venography/embolization for pelvic venous congestion.

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Abstract

We present a case of pelvic venous congestion in a 13-year-old girl who complained of pelvic pain for 9 months. The diagnosis of pelvic congestion syndrome was suggested by imaging modalities, including sonography, CT and MRI, with classically described imaging findings. The girl underwent diagnostic laparoscopy, where visual inspection demonstrated congested pelvic veins and endometriosis. After removal of endometrial implants, the child's pain persisted and she subsequently underwent venography and embolization of the ovarian veins. We found no literature describing pelvic venous congestion (PVC) in children. Knowledge that PVC exists in children is important, particularly for pediatric radiologists who are imaging patients with complaints of pelvic pain.
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Abstract

We present a case of pelvic venous congestion in a 13-year-old girl who complained of pelvic pain for 9 months. The diagnosis of pelvic congestion syndrome was suggested by imaging modalities, including sonography, CT and MRI, with classically described imaging findings. The girl underwent diagnostic laparoscopy, where visual inspection demonstrated congested pelvic veins and endometriosis. After removal of endometrial implants, the child’s pain persisted and she subsequently underwent venography and embolization of the ovarian veins. We found no literature describing pelvic venous congestion (PVC) in children. Knowledge that PVC exists in children is important, particularly for pediatric radiologists who are imaging patients with complaints of pelvic pain.

References

Smith MS, Tyler DC, Womack WM et al (1989) Assessment and management of recurrent pain in adolescence. Pediatrician 16:85 Hulka JF, Peterson HB, Phillips JM et al (1993) American Association of Gynecologic Laparoscopists 1991 membership survey. J Reprod Med 38:569 Kontoravdis A, Hassan E, Hassiakos D (1999) Laparoscopic evaluation and management of chronic pelvic pain during adolescence. Clin Exp Obstet Gynecol 26:76 Coakley FV, Varghese SL, Hricak H (1999) CT and MRI of pelvic varices in women. J Comput Assist Tomogr 23:429–434 Kim CY, Miller MJ, Merkle EM (2009) Time-resolved MR angiography as a useful sequence for assessment of ovarian vein reflux. AJR 193:W458–W463 Park SJ, Lim LW, Ko YT et al (2004) Diagnosis of pelvic congestion syndrome using transabdominal and transvaginal sonograpy. AJR 182:683–688 Freedman J, Ganeshan A, Crowe PM (2010) Pelvic congestion syndrome: the role of interventional radiology in the treatment of chronic pelvic pain. Postgrad Med J 86:704–710 Asciutto G, Asciutto KC, Mumme A et al (2009) Pelvic venous incompetence: reflux patterns and treatment results. Eur J Vasc Endovasc Surg 38:381–386 Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Wassong, C., Shah, B., Kanayama, M. et al. Radiologic findings of pelvic venous congestion in an adolescent girl with angiographic confirmation and interventional treatment. Pediatr Radiol 42, 636–640 (2012). https://doi.org/10.1007/s00247-011-2232-y Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00247-011-2232-y

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Condition tags

endometriosischronic_pelvic_pain

MeSH descriptors

Diagnostic Imaging Endometriosis Hyperemia Pelvic Pain Pelvis Adolescent Diagnosis, Differential Endometriosis Endometriosis Female Humans Hyperemia Hyperemia Pelvic Pain Pelvic Pain Pelvis

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