Ovarian Vein Thrombosis: A Rare Cause of Abdominal Pain Outside the Peripartum Period

Heavrin, Benjamin S.; Wrenn, Keith

doi:10.1016/j.jemermed.2007.05.034

Cited by 42 publications

(49 citation statements)

References 9 publications

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“…OVT is developed 0.05% to 0.18% of deliveries [3,4]. In one study, OVT is affected in 1 in 200 cases of febrile abortion [5]. The incidence outside the postpartum period is not evaluated, but it can be associated with PID, recent gynecological surgery, underlying malignancy, and hypercoagulable state.…”

Section: Discussionmentioning

confidence: 99%

“…It causes blood fl ow stasis and at term, the diameter of the ovarian vein increases to 3 times larger than that of ovarian vein before pregnancy. Blood fl ow in the ovarian vein rapidly decreases right after delivery [5]. The OVT, which is not associated with pregnancy, also is predominantly occurred in the right ovarian vein [3,7].…”

Section: Discussionmentioning

confidence: 99%

“…This retrograde drainage pattern from the left ovarian vein and anterograde fl ow into the right ovarian vein, especially in the presence of PID, may expose the right ovarian vein to an infectious environment [5]. Early diagnosis of ovarian vein thrombosis is essential to prevent life-threatening sequelae.…”

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A case of ovarian vein thrombosis with acute pelvic inflammatory disease

Huh

Lee

Jeon

et al. 2011

Korean J Obstet Gynecol

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When a women patient presents to the hospital with lower abdominal pain, the accurate diagnosis of ovarian vein thrombosis (OVT) could be easily delayed because it is a rare cause. This diagnosis should be considered not only in postpartum patients but also in women with pelvic infl ammatory disease (PID). We report a case of OVT along with PID, which is detected by a computed tomography scan and treated successfully with anticoagulation therapy.Keywords: Ovarian vein; Thrombosis; Pelvic infl ammatory disease CASE REPORT Received: 2011. 5.11. Revised: 2011. 7.27. Accepted: 2011 Ovarian vein thrombosis (OVT) is a rare cause of acute abdominal pain, and it affects approximately 1 in 2,000 deliveries or abortion [1]. However, this diagnosis should be considered not only in postpartum patients but also in women with pelvic infl ammatory disease (PID), with malignancy, who went through recent abdominal surgery, or has known hypercoagulable state [2]. Common symptoms of OVT are fever, nausea, vomiting, chills, lower abdominal pain, tachycardia, and fl ank pain. The clinical manifestations are variable from asymptomatic and dull abdominal pain to sepsis, pulmonary embolism and life threatening events. The complications of OVT can be significant, so careful diagnosis, which is based on computed tomography (CT), color Doppler ultrasonography and magnetic resonance imaging (MRI), is important [3]. Differential diagnosis must be included appendicitis, peritonitis, adnexal torsion, tubo-ovarian abscess, ectopic pregnancy, intussusception, and pyelonephritis [1]. We report a case of a patient presenting with OVT which is accompanied with PID, and review the diagnostic and therapeutic options for this disease. Case ReprotA 27-year-old healthy nulliparous woman was visited Gangnam Severance Hospital emergency department with one day of aggravating right lower quadrant pain. The past medical history and review of systems were not remarkable. There was no family history of hypercoagulable state. Transvaginal ultrasound was within normal range. The abdomino-pelvic CT revealed mild pelvic ascites with smooth peritoneal thickening which is suggesting PID. She was admitted to gynecologic department under the impression of PID and received an intravenous aminoglycoside and metronidazole for 8 days as a empirical antibiotic treatment. She had vaginal discharge and the result of cervical culture was positive for gardnerella and chlamydia. The patient was discharged after 8 days hospital stay with mild improvement in her symptom. She was to continue 1 week of oral aminoglycoside and metronidazole. After 5 days, she revisited emergency department for recurrent abdominal pain, which is more aggravated and localized at right lower quadrant area. On physical examination, the patient had

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A case of ovarian vein thrombosis with acute pelvic inflammatory disease

Huh

Lee

Jeon

et al. 2011

Korean J Obstet Gynecol

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“…난소정맥혈전증은 전형적인 증상이 없어 진단이 어렵고 뒤늦게 영상 학적인 검사를 통해 우연히 발견되어 치료되는 경우가 많다. 지금까지 알려진 대부분의 예는 산후기에 진단되었고 임신과 연관이 있는 것으 로 알려져 있으며 그 외 다른 선행요인으로는 골반감염성질환, 최근의 복부 수술, 부인과적 악성종양 또는 응고장애 등이 있는 것으로 보고되 고 있다 [5,6]. 유산이나 원인불명의 이유로 난소정맥혈전증이 발생하는 경우는 극히 드물다 [6,7].…”

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“…지금까지 알려진 대부분의 예는 산후기에 진단되었고 임신과 연관이 있는 것으 로 알려져 있으며 그 외 다른 선행요인으로는 골반감염성질환, 최근의 복부 수술, 부인과적 악성종양 또는 응고장애 등이 있는 것으로 보고되 고 있다 [5,6]. 유산이나 원인불명의 이유로 난소정맥혈전증이 발생하는 경우는 극히 드물다 [6,7]. 난소정맥혈전증은 산후기 여성의 0.05-0.18%에서 보고되며 그 중 80-90%에 달하는 환자에서 오른쪽 난소정맥을 침범한다 [8] …”

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Bilateral ovarian vein thrombosis after abortion: A case report

Cho

Park

et al. 2011

Korean J Obstet Gynecol

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The frequency of thromboembolism is 0.3-1.2% in pregnant women, in most cases occur in veins. Especially, ovarian vein thromboses present rarely that occur in 0.02-0.18% of pregnancy. Ovarian vein thromboses are diagnosed mainly on right side, rarely bilateral or left side involvement. Ovarian vein thromboses are caused by physiologic hypercoagulability, endothelial injury, and compression of uterus during pregnancy. Mostly it occurs at postpartum. In the cases of ovarian vein thrombosis after abortion, it is very rarely reported in domestic and foreign. We report the case of bilateral ovarian vein thrombosis that was presented after abortion in early pregnancy with brief review of literature.

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