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Case Reports
. 2019 Jun 21;12(6):e228399.
doi: 10.1136/bcr-2018-228399.

Postpartum ovarian vein thrombosis and venous anatomical variation

João Abrantes  1 , Eliana Teixeira  1 , Fernanda Gomes  1 , Clara Fernandes  1
Affiliations
Case Reports

Postpartum ovarian vein thrombosis and venous anatomical variation

João Abrantes et al. BMJ Case Rep. .

Abstract

A 34-year-old multipara presented 72 hours postpartum with acute right-sided abdominal pain. The investigation revealed mild leucocytosis with positive D-dimer and elevated C reactive protein. Abdominal ultrasound and abdominopelvic CT demonstrated an enlarged right ovarian vein with endoluminal thrombus, representing postpartum ovarian vein thrombosis. The patient became asymptomatic 48 hours after starting broad-spectrum antibiotic treatment and anticoagulant therapy. She completed the treatment in ambulatory regimen and control abdominopelvic CT imaging was performed and revealed a duplicated right ovarian vein and a small residual subacute thrombus in the lumen of the distal right ovarian vein. The patient remained asymptomatic in the clinical follow-up.

Keywords: gynecology; pregnancy; radiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Ultrasound image of the right adnexal region depicting a hypoechoic tubular structure representing the thrombosed right ovarian vein.
Figure 2
Figure 2
Abdominopelvic CT scan with iodine contrast illustrating the marked dilatation and tortuosity of the right ovarian vein (solid arrows), with lack of endoluminal enhancement, representing acute ovarian vein thrombosis.
Figure 3
Figure 3
Follow-up abdominopelvic CT scan with iodine contrast detailing the residual endoluminal thrombus (solid arrow) in the inferior segment of the right ovarian vein.
Figure 4
Figure 4
Maximum intensity projection coronal view of follow-up abdominopelvic CT scan with iodine contrast portraying the duplication (solid and open arrows) of the right ovarian vein.
See this image and copyright information in PMC

References

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