Puerperal Ovarian Vein Thrombophlebitis

 

Onset is usually 2-4 days after delivery. Most patients have a post-partum endometritis but the thrombosis may also be sterile.

 

Clinical findings:

(1) right lower quadrant pain mimicing acute appendicitis (right ovarian vein)

(2) left lower quadrant pain mimicing a ruptured ovarian cyst

(3) the thrombosed vessel(s) may be palpable adjacent to uterine cornua

 

Findings in suppurative thrombophlebitis:

(1) fever

(2) tachycardia

(3) chills

 

Imaging studies show thrombosis of one or both ovarian veins.

 

Complications were more serious prior to the availability of antibiotics:

(1) pulmonary embolism (with tachypnea, respiratory distress)

(2) sepsis

(3) metastastic abscesses