Best Irwin M
Interventional Radiology, Department of Radiology, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA.
Case Rep Vasc Med. 2011;2011:140389. doi: 10.1155/2011/140389. Epub 2012 Jan 9.
Symptomatic iliac fossa and suprapubic varicosities are uncommon presentations in adults. Such presentations often point to acquired obstructive process to pelvic outflow or to the progression of venous insufficiency and reflux in the pelvic and gonadal veins. Less frequently, venous anomalies of the renal veins or IVC might be implicated. Furthermore, late presentations of congenital or acquired developmental abnormalities might become manifest. As this case illustrates, a thorough understanding of the underlying pathologic process and the anatomical derangement must be sought before any treatment is instituted. Unnecessary extirpation of these varicosities would simply have removed vital physiologic cross-pelvic collateral circulation from the lower extremity in the face of chronic iliac vein occlusion.
有症状的髂窝和耻骨上静脉曲张在成人中并不常见。此类表现往往提示盆腔血流出现后天性梗阻过程，或盆腔及性腺静脉中静脉功能不全和反流的进展。较少见的情况下，可能涉及肾静脉或下腔静脉的静脉异常。此外，先天性或后天性发育异常的晚期表现可能会显现出来。正如本病例所示，在采取任何治疗措施之前，必须深入了解潜在的病理过程和解剖结构紊乱情况。面对慢性髂静脉闭塞，不必要地切除这些静脉曲张只会消除下肢重要的生理性盆腔交叉侧支循环。
