Clinical manifestations of pelvic varicose veins

Pelvic varicose veins are mainly caused by women not paying attention to their sitting posture in life. It is the most common gynecological disease. For a disease like pelvic varicose veins, we should have a certain understanding of its symptoms, so that we can better treat the disease. I hope you can understand.

Lesion characteristics and clinical manifestations

From an anatomical point of view, there are many pelvic veins distributed in a plexus-like manner. Each venous plexus is connected by mutual communicating branches, and the walls of the veins are weak. Most of them have no venous valve structure, and the blood flow is relatively slow, lacking the corresponding arterial pulsation to assist the return. The pelvic tissue structure is loose and lacks support, and is easily affected by factors such as increased abdominal pressure, resulting in poor venous return and the formation of this disease. The main pathological changes in the pelvis are uniform enlargement of the uterus, congestion and edema of the endometrium and subserosal veins, edema and enlargement of the cervix, and edema of the ovaries, which may sometimes appear cystic. The uterine vein and bilateral ovarian veins may be significantly tortuous and dilated.

The main clinical symptoms include pain in the lumbar and lower abdomen, which worsens before menstruation, as well as menstrual disorders, dark red menstrual flow, and prolonged menstruation.

Sonographic performance

Transabdominal two-dimensional sonogram: 1 The uterus is slightly and uniformly enlarged, with varying degrees of retroversion and flexion. 2 The sides of the uterus and the adnexal area show beaded or honeycomb-shaped echo-free areas, with the widest inner diameter of approximately 0.5 to 0.8 cm. In severe cases, it can lead to obstruction of small veins and lymphatic return in the uterine muscle wall and dilation of tiny veins into venous sinuses. The sonogram shows thickening of the uterine wall with a grid-like anechoic area inside. The dilated blood vessels in the uterine wall can also be seen to be interconnected, and cloudy, slow-flowing blood can be seen in the varicose veins.

Color Doppler blood flow detection

CDFI has unique value in the diagnosis of this disease and can further verify whether the above two-dimensional images contain dilated veins. The main manifestation is the above-mentioned beaded or honeycomb-like echo-free area beside the uterus, showing blue and red color blood flow signals. The color is relatively dark, and sometimes thickened serpentine colored blood flow bundles can be seen, connecting to each other to form thick lake-like colored spots. In severe cases, the dilated blood sinuses in the anterior and posterior myometrium of the uterus are interconnected and form a "colored ball" shape. The spectral Doppler display of the corresponding part is a continuous, low-speed, non-fluctuating spectrum.

The above ultrasound manifestations combined with clinical findings can highly suggest or diagnose this disease. However, care should be taken to differentiate it from other diseases that cause pelvic congestion syndrome. The main causes include compression, stenosis or obstruction of the common iliac vein and thrombosis in the iliac vein, which can also lead to extensive congestion, dilation and tortuosity of the pelvic veins, with similar sonograms and CDFI. However, careful tracking upwards to see if there are any changes in the above-mentioned blood vessels and the images of the pelvic mass, and most of the time, unilateral venous dilatation can be used for differentiation.

Clinical significance

Although X-ray pelvic venography is a reliable method for diagnosing pelvic venous congestion, it is somewhat damaging and is limited by certain conditions. Ultrasound examination is simple and easy to perform, especially CDFI, which can indicate the diagnosis of pelvic congestion at an early stage. It can clearly show the severity and scope of venous congestion and can also be graded. Transabdominal ultrasound can also be used to differentiate from other pelvic vascular diseases. Therefore, ultrasound examination is the first choice for diagnosing pelvic congestion.

After reading the above article about pelvic varicose veins, female friends must understand the seriousness of this symptom. Do not ignore this symptom and avoid causing consequences that will make female friends regret it. Friends whose conditions are serious should carefully choose surgical treatment and take preventive measures to avoid suffering from gynecological diseases.