Author: Dr. Ed Gabitoya
Ed D. Gabitoya, MD, Ma. Barbra A. Destajo, MD, ThessieMinelli Valdez, Rosella S. Arellano, MD, Marvin T. Tamaña, MD Philippine Heart Center
INTRODUCTION It was estimated that about one-third of women will experience chronic pelvic pain in their lifetime.1 One of the difficult to diagnose cause may be secondary to a hard-to-find varices in the pelvic region, known as pelvic congestion syndrome. This is a painful condition often caused by dilatation of the ovarian and/or pelvic veins and the presence of pelvic varices is usually incidental during pelvic imaging or during surgical intervention for obstetric or gynecologic indications. Often than not, most patients with pelvic varices are asymptomatic2 and when symptoms are present, it is highly variable and may mimic that of other gynecologic and gastrointestinal pathologies. The diagnosis and management of pelvic congestion syndrome continues to challenge all physicians and this clinical entity is often underestimated, maybe because of the limited awareness regarding this condition. Patients suffering from pain related to pelvic varices usually undergo a long and inconclusive diagnostic workup before the exact cause of symptoms is recognized.3 Management also remained a challenge and recent advancements in radiologic intervention1,4-6 has paved the way for opportunities to improve treatment of pelvic congestion syndrome. We present this first case of pelvic congestion syndrome managed in our institution treated with combined coil and chemical pelvic vein embolization. A heightened awareness and clinical suspicion for the specific symptomatology, associated findings and appropriate use of imaging modalities for this condition may bring about a more rapid progression toward treatment and improved quality of life.