Ovarian vein thrombosis and sigmoid diverticulitis

CT scan of the abdomen was performed in this 58-year old lady because ofLower abdominal pain in the lower abdomen sincefor 2 days andassociated with fever. Leucocytosis and CRP were both elevated.

This patient has a history of previous appendectomy and extirpation extirpation of the uterus.

Ovarian vein thrombosis is an uncommon but potentially serious disorder. It arises 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 hypercoagulabilityhypercoagulabilities, 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 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.

Thrombosis

CT demonstrates multiple sigmoid colon diverticula with surrounding mesenteric fat stranding. These findings are compatible with diverticulitis. On the left lateral side of the left ovariansigmoid colon, a dilated venous structure is seen with an endoluminal round thrombus. This vein

is well demonstrated on these images (see image description for more details)drains into the left renal vein. Left renal vein and inferior vena cava are normal.