Laparoscopic Transperitoneal Gonadal Vein Ligation for Treatment of Pelvic Congestion Secondary to Nutcracker Syndrome: A Case Report
Vichit Viriyaroj MD*, Prinya Akranurakkul MD*, Bunlung Muyphuag MD*, Maethaphan Kitporntheranunt MD**
Affiliation : * Department of Surgery, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand ** Department of Obstetrics & Gynecology, Faculty of Medicine, Srinakharinwirot University, Nakhon Nayok, Thailand
Nutcracker syndrome is the term used to describe the patient with clinical symptoms of entrapment of the left renal vein between the aorta and the superior mesenteric artery. Pelvic congestion syndrome, which is a cause of chronic pelvic pain in women, may be due to Nutcracker syndrome. There are many modalities of treatment for Nutcracker syndrome. This is a case report of a 32-year old woman with pelvic congestion syndrome due to Nutcracker syndrome, who subsequently underwent laparoscopic transperitoneal left gonadal vein ligation. She has had complete remission of pain in 4 months after the operation and after 12 months of follow-up. Laparoscopic transperitoneal gonadal vein ligation is an approach that is safe, simple and provides good results for patient with pelvic congestion syndrome secondary to Nutcracker syndrome.
Keywords : Nutcracker syndrome, Pelvic congestion syndrome, Laparoscopic gonadal vein ligation, Chronic pelvic pain, Entrapment of left renal vein
