Postpartum ovarian vein thrombosis
Right lower quadrant pain and fever two weeks postpartum.
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A tubular hypoechoic structure starting from the right ovary, anterior to the right psoas muscle and draining into the IVC, all of which identifies this structure as the right ovarian vein.
It is distended with hypoechoic thrombus and the walls of the vein are thickened and slightly echogenic. On Doppler examination, no flow is seen.
The thrombus does not extend into the IVC.
The ovarian vein should be checked for patency in postpartum patients complaining of right lower quadrant pain and fever. In the majority of ovarian vein thrombosis cases, the right ovarian vein is involved.
Ultrasound diagnosis may be difficult due to bowel gas, and care should be taken not to confuse a dilated ureter with a thrombosed ovarian vein.