Idiopathic Bilateral Ovarian Vein Thrombosis in a Non-Pregnant Healthy Patient: A Case Report and Review of the Literature

Abstract

Ovarian vein thrombosis (OVT) is a potentially life-threatening condition, and it is typically related to the peripartum period; however, it is also associated with pelvic inflammatory disease, recent pelvic or abdominal surgery, inflammatory bowel disease, thrombophilia, malignancy, and sepsis. Idiopathic isolated OVT is rare and is usually presented as case reports in the medical literature. In this report, we present a case of bilateral OVT in a postmenopausal female with no identifiable risk factors and normal coagulation profile workup to highlight the importance of considering it as a differential diagnosis in female patients presenting with abdominal pain. Early identification can prevent potentially life-threatening complications. Management is often conservative, and the choice of anticoagulation is based on the patient's medical conditions. In this particular scenario, the patient was managed with low molecular weight heparin (LMWH) and transitioned to direct oral anticoagulant (DOAC) before discharge.

Keywords: bilateral thrombosis; idiopathic ovarian vein thrombosis; ovarian vein thrombosis.

Figure 1. CT image showing filling defect in the right and left gonadal vein (red arrows)

CT: computed tomography

Figure 2. CT of the abdomen (coronal section) showing bilateral OVT as indicated by the red arrows

CT: computed tomography; OVT: ovarian vein thrombosis; AO: abdominal aorta; IVC: inferior vena cava; LRV: left renal vein