EURORAD ESR

Case 8981

Young woman with deep pelvic pain (ECR Case of the Day)

Author(s)
Ros Mendoza L, Martínez E, Marín MA, Artigas JM.
Department of Radiology, Hospital Miguel Servet, Zaragoza, Spain.
 
Patient
female, 14 year(s)
 
 
  • Figure 1
    Fig 1

    Figure 1. Sagittal conventional grey-scale US scan of the pelvis shows normal uterus and urinary bladder. There is a fluid-filled bowel loop in a retrouterine location mimicking peritoneal fluid.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound;
     
     
  • Figure 2
    Fig 2

    Figure 2. Transversal conventional grey-scale US scan of the pelvis shows normal uterus and tortuous, microcystic-like structures in a both parauterine areas.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound;
     
     
  • Figure 3
    Fig 3

    Figure 3. Transversal US scan slightly caudal to fig. 2 demonstrates an anechoic, left paraovarian, tubular structure. The bowel loop described on fig 1 is also present here in a rigth, retrouterine location.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound;
     
     
  • Figure 4
    Fig 4

    Figure 4. Transversal US color-Doppler examination of the pelvis demonstrates bilateral tortuous vascular venous structures located in parauterine areas, corresponding with hypoechoic images seen in grey-scale US...

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound-Colour Doppler;
     
     
  • Figure 5
    Fig 5

    Figure 5. Transversal US power-Doppler examination (same level than fig 3) clearly shows tortuous ovarian and parauterine vessels.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound-Power Doppler;
     
     
  • Figure 6
    Fig 6

    Figure 6. Sagittal US power-Doppler scan of the left adnexal zone confirms the presence of parauterine and ovarian varices.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: Ultrasound-Power Doppler;
     
     
  • Figure 7
    Fig 7

    Figure 7. Helical CT scan after IV contrast-medium administration confirms bilateral parauterine varices. Both studies CT and US were performed the same day.

     
    Area of Interest: Genital / Reproductive system female; Imaging Technique: CT;
     
     
  • Figure 8
    Fig 8

    Figure 8. Transverse contrast-enhanced abdominal CT scan shows engorgement of the left ovarian vein.

     
    Area of Interest: Veins / Vena cava; Imaging Technique: CT;
     
     
Figure 1. Sagittal conventional grey-scale US scan of the pelvis shows normal uterus and urinary bladder. There is a fluid-filled bowel loop in a retrouterine location mimicking peritoneal fluid.
 
Figure 2. Transversal conventional grey-scale US scan of the pelvis shows normal uterus and tortuous, microcystic-like structures in a both parauterine areas.
 
Figure 3. Transversal US scan slightly caudal to fig. 2 demonstrates an anechoic, left paraovarian, tubular structure. The bowel loop described on fig 1 is also present here in a rigth, retrouterine location.
 
Figure 4. Transversal US color-Doppler examination of the pelvis demonstrates bilateral tortuous vascular venous structures located in parauterine areas, corresponding with hypoechoic images seen in grey-scale US examination.
 
Figure 5. Transversal US power-Doppler examination (same level than fig 3) clearly shows tortuous ovarian and parauterine vessels.
 
Figure 6. Sagittal US power-Doppler scan of the left adnexal zone confirms the presence of parauterine and ovarian varices.
 
Figure 7. Helical CT scan after IV contrast-medium administration confirms bilateral parauterine varices. Both studies CT and US were performed the same day.
 
Figure 8. Transverse contrast-enhanced abdominal CT scan shows engorgement of the left ovarian vein.
 
 
 
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