Abstract

Pelvic congestion syndrome (PCS) is a genital, parietal or visceral pelvic syndrome manifesting as chronic pelvic pain, favored by multiparity, sedentary lifestyle and excess weight.

PCS causes post-coital pain, dyspareunia, dysmenorrhea, and more rarely urinary or neurological disorders, affecting patients’ psychological health.

Etiologies are dominated by Nutcracker syndrome, Cockett’s syndrome, thrombosis and venous insufficiency. Doppler ultrasound is the 1st-line examination for making the diagnosis and performing a dynamic study using the Valsalva maneuver.

In our patient, the PCS was due to valvular incompetence, resulting in reversal of venous flow and causing pelvic and genital varicose veins of the lower limbs.

CT confirmed the diagnosis, showing dilatation of the left renal vein and homolateral ovarian vein due to venous insufficiency, and ruled out other etiologies.