Floating caval thrombus arising from the ovarian vein.
We describe the case of a 37-year-old pregnant woman, who was admitted to hospital for suspicion of chorioamnionitis. An emergency C-section was performed. Four days later, the patient suffered from abdominal pain and fever. Computed tomographic scanning demonstrated only a thrombosis of the right ovarian vein. Anticoagulation and antibiotic therapy was started immediately. Color duplex imaging performed 3 days later revealed a free-floating caval thrombus reaching the confluence of hepatic veins while the patient was fully anticoagulated. Emergency thrombectomy was performed by laparotomy, and the thrombus was removed by caval incision during suprahepatic clamping of the inferior vena cava. The patient recovered rapidly from surgery and was discharged on the tenth postoperative day.
Kuehnl
Andreas
A
Clinic for Vascular Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
Assadian
Afshin
A
Reeps
Christian
C
Schneider
Karl-Theo Maria
KT
Stangl
Manfred
M
Berger
Hermann
H
Eckstein
Hans-Henning
HH
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D002585:Cesarean Section / Q000009:adverse effects*; D002821:Chorioamnionitis / Q000601:surgery*; D003131:Combined Modality Therapy; D004638:Emergency Treatment; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D010053:Ovary / Q000098:blood supply*; D010690:Phlebography / Q000379:methods; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011655:Pulmonary Embolism / Q000209:etiology; D017131:Thrombectomy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000601:surgery; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery / Q000628:therapy
D000900:Anti-Bacterial Agents; D000925:Anticoagulants