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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


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This varicocele has become painful. What has happened?


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


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


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


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During straining there is increased flow


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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.


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There is still flow in the left renal vein


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


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There is reflux with color doppler


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This patient had a renal cell carcinoma


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The tumor has invaded the left renal vein


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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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