Iliac vein compression syndrome: an unusual cause of varicocele

Iliac vein compression syndrome is the phenomenon of nonthrombotic iliac vein obstruction caused by compression of left iliac vein between the right iliac artery and fifth lumbar vertebra. Affected patients usually present with unilateral leg edema. The condition is most often seen in women, in whom it may also be a cause of vulvar varicosities. Presented here is a case of idiopathic iliac vein obstruction associated with an ipsilateral varicocele in a young man. This varicocele was caused by multiple collateral venous channels and was resistant to surgical high ligation. This case illustrates an unusual cause of varicocele formation and an anatomic reason for failure of standard surgical therapy.