title: Postpartum ovarian vein thrombosis.
abstract: BACKGROUND
  Ovarian vein thrombosis (OVT) is a rare but potentially serious postpartum complication, which occurs in 0.05% to 0.18% of pregnancies and is diagnosed on the right side in 80% to 90% of the cases.
  
  
  METHODS
  A 32-year-old woman presented at 15 days postpartum to our emergency department with severe abdominal pain, fever, and abdominal distension. Abdominal examination revealed right lower quadrant pain with rebound tenderness. The plain abdominal radiography evidenced a diffuse fecal stasis; abdominal ultrasound showed the presence of free fluid in the Douglas' pouch and between small bowel loops. Diagnosis of acute appendicitis was made. The patient immediately underwent explorative laparoscopy; at surgery, a woody tumoration consistent with right ovarian vein thrombosis was found. Laparoscopic ultrasound confirmed the diagnosis. Anticoagulation therapy and antibiotics were instituted. CT-scan confirmed the presence of thrombosis up to the vena cava. The patient was discharged on postoperative day 4. At 1-month follow-up, she remained stable and symptom free.
  
  
  CONCLUSIONS
  Even though postpartum ovarian vein thrombosis is rare, recognition and treatment is needed to institute adequate therapy and avoid potential serious sequelae. The diagnosis can be established by ultrasound, CT scan, and MRI examinations, although, as in the case described, the limitation of ultrasound includes obscuration of the gonadic vein by overlying bowel gas.
  
  
  CONCLUSIONS
  OVT should be considered in any woman in the postpartum period with lower abdominal pain, fever, and leucocytosis.
authors: Health Unit 5 Pisa, Pontedera Hospital, General Surgery Unit, Via Roma 180, Pontedera, Italy, 56025. basili.giancarlo@acoi.it
authors: Giancarlo
authors: G
authors: Basili
authors: Nicola
authors: N
authors: Romano
authors: Marco
authors: M
authors: Bimbi
authors: Luca
authors: L
authors: Lorenzetti
authors: Dario
authors: D
authors: Pietrasanta
authors: Orlando
authors: O
authors: Goletti
mesh_terms: D000328:Adult; D019160:Endosonography; D005260:Female; D006801:Humans; D010053:Ovary / Q000098:blood supply*; D011644:Puerperal Disorders / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D018615:Ultrasonography, Doppler, Color; D020246:Venous Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery