That should be " the peripheral uterine vasculature is often increased completel"
On Thursday, November 29, 2018, 1:02:01 PM EST, Audrey Fleming <[log in to unmask]> wrote:
The SVU has a new document out for this. Not sure if I really agree with it, but it is there. if your patient is slim then you'll probably be OK and can see. If the patient is female and a larger size good luck.
I have always seen the pelvic veins close to the uterus and ovaries with pelvic congestion in women. In men then you need to look for scrotal varices and see if the go up the canal and into the pelvic area.
In women, TV scanning has always been my best method to diagnose this. But I am not aware of any vascular labs that have a TV transducer and a person trained in pelvic imaging. This is where having a good relationship with a general/gyne scanning lab can become important. If the pelvic congestion is bad enough you can often see the ovarian/gonadal vein incompetent to the renal vein, so that's an aspect to look at.
The traditional symptoms of pelvic congestion are a fullness, uncomfortable adnexa, chronic pelvic pain (around menses for women), heaviness etc. If you can image the uterus, and are comfortable with a normal sonographic image vs abnormal, the peripheral uterine musculature is often increased completely around the uterus or predominantly on one side. I find uterine adenomyosis is many women with ( suspected) pelvic congestion. Also having a scan to look for oavrian and uterine pathology could be considered. endometriosis can cause things to stick together and cause vascular issues also in women.
Often the overlying bowel gas limits transabdominal imaging. Try using valsalva and/or standing to get the pelvic veins to dilate.
Hope this helps,
Audrey
On Thursday, November 29, 2018, 12:08:18 PM EST, Nicole Ball <[log in to unmask]> wrote:
Good afternoon all.
I had a reflux patient recently whomwill be coming back for Iliac Vein imaging to determine Pelvic congestion/reflux& pelvic varicosities around the iliacs. I have not done an examlike this before and was wondering if anyone has a protocol or tips? Thankyou in advance...
Sincerely,
Nicole Ball, BS, RVT
http://nnevs.org/
Frisbie Memorial Hospital
Vascular Lab
Rochester, NH
(w) 603-332-3100 ext 8127
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