Ovarian vein thrombosis and sigmoid diverticulitis
CT scan of the abdomen was performed in this 58-year old lady because of pain in the lower abdomen since 2 days and fever. Leucocytosis and CRP were both elevated.
Abdominal CT-scan (monophasic)
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This patient has a history of previous appendectomy and extirpation of the uterus.
Ovarian vein thrombosis is an uncommon but potentially serious disorder. It arises out of the coincident conditions of venous stasis and hypercoagulability, which are commonly present in the recently postpartum patient. Other conditions that are associated with hypercoagulability, such as recent surgery, malignancy, and Crohn disease, also increase the patient's risk for ovarian vein thrombosis.
In this case the thrombosis of the left ovarian vein is likely to be caused by a concurrent sigmoid diverticulitis adjacent to the left ovarian vein. Vessel wall abnormalities occur during acute inflammation due to sticking and emigration of leukocytes, and the resultant exposed subendothelial collagen activates platelets leading to thrombosis.
- Wittram C. Sigmoid diverticulitis presenting as unilateral iliofemoral vein thrombosis. Abdom Imaging. 19 (3): 257-8. - Pubmed citation