Postpartum ovarian vein thrombosis

Case contributed by Dr Abdulrahman Abdo Ali Abbas

Presentation

Day 7 of an uneventful post vaginal delivery, she developed spikes of fever and right lower abdominal pain and tenderness ? appendicitis

Patient Data

Age: 30 years
Gender: Female
MRI

Pelvis

Coronal and axial T2-weighted images demonstrate an enlarged and tortuous right ovarian vein showing loss of signal void. Contrast-enhanced axial and sagittal T1-weighted image reveals postcontrast enhancement of the vessel wall, edema and minimal fluid collection seen also in the right lower abdomen and around the right adnexa. There is an enlarged postpartum uterus with endometrial fluid.

Case Discussion

Postpartum ovarian vein thrombosis is rare, however, can cause serious complications as IVC thrombosis and pulmonary thrombo-embolism. Clinical findings are nonspecific and the patient commonly present with right lower quadrant pelvic pain, fever, and leukocytosis.

The imaging modalities play an important role in these conditions, Doppler ultrasound and contrast-enhanced studies are the initial primary non-invasive modalities but MRI is more specific for diagnosis of ovarian vein thrombosis as it is more sensitive for alteration of blood flow.

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Case information

rID: 77951
Published: 29th May 2020
Last edited: 31st May 2020
Inclusion in quiz mode: Included
Institution: cairo university

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