Bilateral Ovarian Vein Syndrome

A Case Report on Ovarian Vein Syndrome

“…Ovarian vein syndrome was first reported by Clark in 1964 1 , who attributed the rare ureteral obstruction, to the normal anatomic relationship between the ureter and the ovarian vein. Since this initial description, various authors have implicated different factors which may cause or contribute to the its pathogenesis: an increase in pressure of the dilated ovarian vein 2,3 , presence of an aberrant ovarian vein 4 , the existence of a fibrous sheath 1 , an ovarian vein thrombosis 5 , or tumors invading the vena cava. 2,6 Anatomically, the gonadal vein passes superiorly and medially to enter the inferior vena cava or renal vein and causes minimal oblique indentation with medial deviation of the ureter in the L3-L5 region and same indentation is seen as it encounters the iliac arteries at the S1 level, as reported by Dure-Smith 4 .…”

“…Since this initial description, various authors have implicated different factors which may cause or contribute to the its pathogenesis: an increase in pressure of the dilated ovarian vein 2,3 , presence of an aberrant ovarian vein 4 , the existence of a fibrous sheath 1 , an ovarian vein thrombosis 5 , or tumors invading the vena cava. 2,6 Anatomically, the gonadal vein passes superiorly and medially to enter the inferior vena cava or renal vein and causes minimal oblique indentation with medial deviation of the ureter in the L3-L5 region and same indentation is seen as it encounters the iliac arteries at the S1 level, as reported by Dure-Smith 4 . A dilated ovarian vein will result in a more pronounced proximal ureteral indentation in the lumbar region than what is normally observed while the ureter is oftentimes fixed to the vein at this level.…”

The Ovarian Vein Syndrome

“…In case of infection of the ureter or the vein a kind of 'buffer coat' might develop and favour an obstruction. The part played by these tissues are therefore considered significant by some authors (25,31,33). Others do not see any relation with the pathology of the ovarian vein and consider the obstruction by periureter ic connective tissues to be embryonic in origin (35) or the consequence of a retrocaecal appendicitis or oophoritis Therapy (26).…”