Tratamento endovascular de síndrome congestiva venosa pélvica em paciente com duplicação de veia cava inferior e anatomia venosa pélvica incomum: revisão bibliográfica / Endovascular treatment of pelvic venous congestion syndrome in a patient with duplication of the inferior vena cava and unusual pelvic venous anatomy: literature review

Resumo A dor pélvica crônica afeta aproximadamente 1/3 de todas as mulheres e é responsável por cerca de 20% de todas as consultas ginecológicas. Os autores relatam um raro caso de congestão venosa pélvica sintomática na presença de duplicação de veia cava inferior e comunicação interilíaca através de veia hipogástrica direita tratado com abordagem endovascular, por embolização das veias varicosas pélvicas e revisão da literatura publicada.

Abstract Chronic pelvic pain affects approximately one-third of all women and is responsible for about 20% of all gynecological consultations. The authors report a rare case of symptomatic pelvic venous congestion in the presence of duplication of the inferior vena cava and inter-iliac communication through the right hypogastric vein that was treated via an endovascular approach with embolization of varicose pelvic veins. The published literature is reviewed.

Duplication of the inferior vena cava: case report and a literaturereview of anatomical variation

Anatomical variation in the inferior vena cava can result in misdiagnosis, making a better understanding of suchvariations crucial. Here we report the case of a 29 year-old male, victim of multiple trauma, who in the courseof treatment presented with a pulmonary thromboembolism confirmed by tomography. Given the gravityof the situation and the need for additional surgeries, a decision was made to implant an inferior vena cavafilter. During phlebography, prior to implantation of the filter, the duplication of the vena cava was detectedand classified as a complete duplication. A review of the literature revealed various anatomical descriptions ofduplicated inferior vena cava, the most common of which were incomplete cases showing greater variationin venous contion. All in vivo anatomical descriptions were done via phlebography, demonstrating the valueof this test for the diagnosis of anatomical variation in the abdominal veins. While duplication of the inferiorvena cava was not the cause of the venous thrombosis in our patient, a detailed phlebography test was neededto both identify the anatomical variation and facilitate the placement of the filter to prevent a new pulmonarythromboembolism.