Ovarian Vein Thrombosis: Incidence of Recurrent Venous Thromboembolism and Survival

Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report

BACKGROUND

Postpartum ovarian vein thrombophlebitis (POVT) is a rare but serious postpartum complication that affects mostly postpartum women. A high index of suspicion is required when faced with sudden postpartum abdominal pain.

CASE SUMMARY

A 25-year-old healthy woman who accepted a vaginal delivery procedure suffered fever (temperature 39.6℃) one day after delivery, accompanied with left lower abdominal pain. Physical examination indicated mild tenderness in the left lower abdomen, accompanied with rebound pain. The patient was confirmed to have left ovarian venous thrombosis with inflammation after receiving a multi-detector row computed tomography scan.

CONCLUSION

POVT is a rare and dangerous postpartum complication. A high index of suspicion is required for the occurrence of ovarian venous thrombosis when faced with postpartum abdominal pain and fever. Early application of Doppler ultrasound, computed tomography, magnetic resonance imaging and other auxiliary examinations is conducive to timely and accurate diagnosis of POVT, thus reducing maternal mortality.

Pelvic Pain in Reproductive Age: US Findings

Pelvic pain in reproductive age often represents a diagnostic challenge due to the variety of potential causes characterized by overlapping clinical symptoms, including gynecological and other disorders (e.g., entero-colic or urological). It is also necessary to determine if there is a possibility of pregnancy to rule out any related complications, such as ectopic pregnancy. Although ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) are strongly integrated, the choice of which is the ideal diagnostic tool should be guided both by clinical suspicion (gynecological vs. non-gynecological cause) and by the risk ratio–benefit (ionizing radiation and instrumental costs), too. The didactic objective proposed by this review consists in the diagnosis of the cause and differential of pelvic pain in reproductive age by describing and critically analyzing the US diagnostic clues of the most frequent adnexal, uterine, and vascular causes.