Retrograde flow in the left gonadal vein at abdominal angiography: an anatomo-physiological review and clinical assessment.

Retrograde flow in the left gonadal vein may be visualized in the venous phase of aortography or renal arteriography. In none of 13 cases was this due to a mass lesion at the renal hilum. Although the Valsalva maneuver may cause this flow reversal in some, in most cases it is due to anatomical structures or variants compressing the renal vein. These are detailed. Left gonadal vein reflux incidentally detected on the aortogram may thus indicate impaired left renal venous drainage and its consequences. There are also clinical and urographic constellations which merit aortography to detect left gonadal vein reflux for their elucidation.