Post partum right ovarian vein thrombosis (thrombophlebitis)

Case contributed by Dr Chris O'Donnell

Presentation

Normal vaginal delivery complicated by retained placenta requiring manual extraction. Now 5 days post partum with persistent fever despite antibiotics and right iliac fossa pain ? appendicitis

Patient Data

Gender: Female

Grossly distended right ovarian vein form the uterus to the IVC containing a heterogeneous mass consistent with thrombus.  The uterus is enlarged (post-partum) with assymetrical swelling on the right lateral aspect associated with increased vascularity (presumed to represent distended veins due to obstruction more distally).  Further oedema within the soft tissues of the pelvis.

Case Discussion

This condition occurs almost exclusively post-partum and usually on the right side.  It is thought to be a thrombophlebitis no doubt exacerbated by the hypercoagulable/prothrombotic state of recent pregnancy.

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Case Information

rID: 45709
Case created: 5th Jun 2016
Last edited: 6th Jun 2016
Inclusion in quiz mode: Excluded

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