Ovarian vein thrombosis is uncommon but can complicate the postpartum period.
The right ovarian vein is affected more often than the left.
Risk factors:
(1) cancer
(2) pelvic infection
(3) inflammatory bowel disease
(4) surgery
(5) trauma
(6) pregnancy and puerperium
(7) oral contraceptives
(8) hypercoagulable state (Factor 5 Leiden, etc)
(9) antiphospholipid antibodies
Clinical findings may include:
(1) lower quadrant or flank pain
(2) fever
(3) variable tender, palpable lower abdominal mass
(4) nausea and vomiting
(5) malaise
(6) ileus
The diagnosis can be made with imaging studies. Ultrasound shows absent blood flow and an anechoic/hypoechoic mass between the ovary and the inferior vena cava. Contrast-enhanced CT or MRI shows a low-density lumen with sharply-defined walls.
Diagnostic laparoscopy can also be used to establish the diagnosis if imaging studies are non-diagnostic.
Complications may include:
(1) ovarian infection
(2) thrombosis of other adjacent veins
(3) sepsis
(4) pulmonary embolism
