Venogram shows what?

[arMD]

These are images of my blood circulation in the arterial and venous phases. I have TVT-o and abdominal mesh inserted 2012 and 2013. Can you think of an explanation for the hyperintense abdominal venous flow? Could it be part of a foreign body response
I had polyester sutures used in sacrospineous hysteropexy also in 2012 but my body rejected them with pain and discharge. Those were removed in 2014 and 2015. The TVT-o has eroded into vagina and I have abdominal swelling and groin pain. The surgeon who inserted the right abdominal mesh confirmed that the area that is hyperintense mirrors where the mesh is.

[drtowfigh]

Venogram shows what?

I am not aware of any studies about this. And I’ve never seen such an intense reaction that can be seen on MR angiography.
My impression is that mesh causes inflammation, which results in increased blood flow to the area, as does scar tissue. This may be a sign of increased inflammatory state.
Why was the MRI done and do you have pain?

[arMD]

Venogram shows what?

Thank you for your reply. I have a lot of pain: Lower back, pelvic and upper legs. The MRA-v was done to look at my pelvic venous flow as this may be the cause of my lower back pain and left leg swelling.

I’ve had 4 DVT’s in my left pelvis and leg (1999, 2008, 2014, 2015) and have been diagnosed with scarring and obstruction in the pelvic venous drainage, specifically my left iliac vein is occluded. I have hetero Factor V Leiden, overzealous, blood clotting disorder. Iliofemoral DVT and May-Thurners Syndrome go together. I take warfarin to stop clots, and duloxetine and pregabelin for pain, anxiety and depression.

I had a great personal trainer who taught me good functional movement over a period of 2 years and now everyone says I look really well! However, my abdomen is actually really swollen and my temperature a little raised. My prolapse is recurring and pain from tvt-o and remaining(?) POP suture throb intensely at night.

[arMD]

Venogram shows what?

If you might share these images on your medical networks (obscuring the personal data), I appreciate it. I have full copies of these fully rotatable images if anyone is interested.

[arMD]

Venogram shows what?

Where would you describe this hyperintense abdominal area as being?

[drtowfigh]

Venogram shows what?

I’ve shared your pictures as you posted them with a group of my hernia colleagues.

Here is my take: this is probably your abdominal wall and/or omentum. If you have iliac vein obstruction, the blood flow needs to get to your liver somehow, and eventually back to your heart, so the veins communicating this back to your heart (abdominal wall, omentum, intestines) will be prominent.

This is most likely not related to your mesh at all. And your pain is also most likely not from the mesh.

[arMD]

Venogram shows what?

Have your colleagues made any suggestions?

[drtowfigh]

Venogram shows what?

The suggestions are as I posted. Not a mesh issue.

[arMD]

Venogram shows what?

Great, thanks for putting my mind at rest. Much appreciated 🙂

[Author]

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