Emergency: requires immediate attention
Ovarian vein thrombosis
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Synopsis
The etiology for this condition is unknown, although it is believed to be related to Virchow's triad of vessel wall injury, venous stasis, and hypercoagulability. It is often discovered incidentally during a work-up for a source of abdominopelvic pain.
Patients present with acute-onset abdominal or flank pain. The predominance of disease occurs on the right side due to the unique anatomy of the right ovarian vein, although disease can be on the left side or bilateral. Fever and/or elevated white blood cell count will often accompany the pain. Most commonly, the patient will be newly postpartum (within the first week or two of delivery). Some patients will present as septic secondary to an infected clot.
When an infection / sepsis occurs in the postpartum period that eventually causes thrombus formation, it is called septic pelvic thrombophlebitis. The concept / management is similar to that of an ovarian vein thrombosis. These patients may or may not appear ill; they may have only fever as their presenting symptom.
Codes
ICD10CM:N83.9 – Noninflammatory disorder of ovary, fallopian tube and broad ligament, unspecified
SNOMEDCT:
264557003 – Ovarian vein syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Renal colic
- Endometritis
- Acute appendicitis
- Nephrolithiasis
- Diverticular disease or abscess
- Ovarian cyst
- Ectopic pregnancy
- Ovarian torsion
- Septic pelvic thrombophlebitis
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Last Reviewed:06/10/2018
Last Updated:10/10/2019
Last Updated:10/10/2019