Pelvic Congestion Syndrome: A Missed Opportunity

Background/Aims Chronic pelvic pain (CPP) is pelvic pain for greater than 6 months with many potential causes one being pelvic congestion syndrome (PCS). PCS is diagnosed by clinical symptoms, exclusion of other etiologies, and imaging. Given the complex nature and diagnosis of CPP, we examined orde...

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Autores principales:	Claire Kaufman, Nancy Ann Little
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	pelvic venous insufficiency pelvic congestion syndrome chronic pelvic pain embolization Medical physics. Medical radiology. Nuclear medicine R895-920
Acceso en línea:	https://doaj.org/article/d992c3c62bb046bcac3a591ef214b430
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spelling	oai:doaj.org-article:d992c3c62bb046bcac3a591ef214b4302021-11-13T23:32:30ZPelvic Congestion Syndrome: A Missed Opportunity0971-30261998-380810.1055/s-0041-1735497https://doaj.org/article/d992c3c62bb046bcac3a591ef214b4302021-07-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0041-1735497https://doaj.org/toc/0971-3026https://doaj.org/toc/1998-3808Background/Aims Chronic pelvic pain (CPP) is pelvic pain for greater than 6 months with many potential causes one being pelvic congestion syndrome (PCS). PCS is diagnosed by clinical symptoms, exclusion of other etiologies, and imaging. Given the complex nature and diagnosis of CPP, we examined ordering and referral patterns in our local population to understand how the imaging findings of PCS correlate with patient symptoms and referral and treatment. Materials and Methods After IRB approval, we searched all 18 to 70-year-old females with CT of the pelvis between March 2015 and March 2018 with the terms “pelvic” plus “congestion,” “varices,” or “vein dilation” in the dictation. Via electronic medical record and image review we collected data regarding demographics, clinical presentation, symptoms, imaging findings, ordering provider, and any follow-up/referrals or interventions regarding PCS. Results A total of 96 patients were included of the 197 studies, with an average age of 47 years and average body mass index of 19.3 (n = 93) at the time of imaging. The reason for imaging was often acute abdominal or flank pain (n = 22) with 38% of cases ordered from the emergency room. Only 72 patients had documentation of clinical evaluation for symptoms of PCS. Notably, only 20 were referred for their symptoms, and only two patients were referred to IR. Both patients underwent successful endovascular intervention. Conclusion CPP is a common cause of morbidity with PCS representing an underdiagnosed cause. We demonstrate that while imaging findings may be incidental, we are failing to capture and triage patients with clinical symptoms of PCS. Radiologists can play a key role in the care of these patients.Claire KaufmanNancy Ann LittleThieme Medical and Scientific Publishers Pvt. Ltd.articlepelvic venous insufficiencypelvic congestion syndromechronic pelvic painembolizationMedical physics. Medical radiology. Nuclear medicineR895-920ENIndian Journal of Radiology and Imaging, Vol 31, Iss 03, Pp 539-544 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pelvic venous insufficiency pelvic congestion syndrome chronic pelvic pain embolization Medical physics. Medical radiology. Nuclear medicine R895-920
spellingShingle	pelvic venous insufficiency pelvic congestion syndrome chronic pelvic pain embolization Medical physics. Medical radiology. Nuclear medicine R895-920 Claire Kaufman Nancy Ann Little Pelvic Congestion Syndrome: A Missed Opportunity
description	Background/Aims Chronic pelvic pain (CPP) is pelvic pain for greater than 6 months with many potential causes one being pelvic congestion syndrome (PCS). PCS is diagnosed by clinical symptoms, exclusion of other etiologies, and imaging. Given the complex nature and diagnosis of CPP, we examined ordering and referral patterns in our local population to understand how the imaging findings of PCS correlate with patient symptoms and referral and treatment. Materials and Methods After IRB approval, we searched all 18 to 70-year-old females with CT of the pelvis between March 2015 and March 2018 with the terms “pelvic” plus “congestion,” “varices,” or “vein dilation” in the dictation. Via electronic medical record and image review we collected data regarding demographics, clinical presentation, symptoms, imaging findings, ordering provider, and any follow-up/referrals or interventions regarding PCS. Results A total of 96 patients were included of the 197 studies, with an average age of 47 years and average body mass index of 19.3 (n = 93) at the time of imaging. The reason for imaging was often acute abdominal or flank pain (n = 22) with 38% of cases ordered from the emergency room. Only 72 patients had documentation of clinical evaluation for symptoms of PCS. Notably, only 20 were referred for their symptoms, and only two patients were referred to IR. Both patients underwent successful endovascular intervention. Conclusion CPP is a common cause of morbidity with PCS representing an underdiagnosed cause. We demonstrate that while imaging findings may be incidental, we are failing to capture and triage patients with clinical symptoms of PCS. Radiologists can play a key role in the care of these patients.
format	article
author	Claire Kaufman Nancy Ann Little
author_facet	Claire Kaufman Nancy Ann Little
author_sort	Claire Kaufman
title	Pelvic Congestion Syndrome: A Missed Opportunity
title_short	Pelvic Congestion Syndrome: A Missed Opportunity
title_full	Pelvic Congestion Syndrome: A Missed Opportunity
title_fullStr	Pelvic Congestion Syndrome: A Missed Opportunity
title_full_unstemmed	Pelvic Congestion Syndrome: A Missed Opportunity
title_sort	pelvic congestion syndrome: a missed opportunity
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/d992c3c62bb046bcac3a591ef214b430
work_keys_str_mv	AT clairekaufman pelviccongestionsyndromeamissedopportunity AT nancyannlittle pelviccongestionsyndromeamissedopportunity
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Pelvic Congestion Syndrome: A Missed Opportunity

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