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Case of the Month

June 2019

Patient Data: Middle age male patient examined for SONOZORG a primary care ultrasound facility

Clinical Info: Patient known to have a varicocele but has now become painfull

This varicocele has become painful. What has happened?

Another image of the same varicocele. If you look carefully the veins are filled with thrombus. So there is a thrombosis of the varicocele.

With color doppler there is only minimal flow along the thrombi in the varicose veins.

This is an ultrasound image of a varicocele in a young boy without thrombus.

During straining there is increased flow

If you look at the left renal vein you can see it is compressed between the aorta and superior mesenteric artery. This is called a nutcracker phenomenon. This can cause many symptoms of which a varicocele is one.

There is still flow in the left renal vein

This is a varicocele in a patient who developed a varicocele at a higher age than usual

There is reflux with color doppler

This patient had a renal cell carcinoma

The tumor has invaded the left renal vein

There are vessels visible in the mass in the renal vein

Beware of varicoceles because they can have a cause other than insufficient valves in the spermatic vein.

For more examples of varicoceles see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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