Left ovarian and renal vein thrombosis after emergency postpartum hysterectomy

Barros, Nuno; Torrão, Maria Manuel; Ferreira, M. R. A.; Pinheiro, Angelina

doi:10.1136/bcr-2016-216292

Cited by 3 publications

(5 citation statements)

References 2 publications

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“…The second case report was published by Barros et al . [ 7 ] The patient underwent total postpartum hysterectomy for severe postpartum vaginal hemorrhage after uneventful vaginal delivery. Twelve days later, she complained of severe lower back pain with no other symptoms.…”

Section: Discussionmentioning

confidence: 99%

Incidental finding of bilateral ovarian and renal veins thromboses post cesarean hysterectomy complicated by ureteric injury

et al. 2022

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This is a case report of a 36-year-old female patient who developed right flank pain on day 4 postcesarean hysterectomy due to placenta accreta and massive bleeding. Ultrasonography of the abdomen and pelvis showed moderate right hydronephrosis. A nephrostomy tube was urgently inserted followed by computed tomography urography which revealed a large pelvic urinoma secondary to right ureter injury and bilateral ovarian and renal veins thrombi. An abdominal drain was inserted and the hematology team was consulted. The patient was treated with enoxaparin with no subsequent complications. Ureteric injury was managed by reimplantation. We reported this case as the probable first presentation of bilateral ovarian and renal vein thromboses postcesarean hysterectomy.

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Section: Discussionmentioning

confidence: 99%

Incidental finding of bilateral ovarian and renal veins thromboses post cesarean hysterectomy complicated by ureteric injury

et al. 2022

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“…Renal vein thrombosis occurs mainly due to systemic hypercoagulable states, the most common being nephrotic syndrome with urinary losses of anticoagulant proteins [4]. Other prothrombotic aetiologies of renal vein thrombosis include hyperhomocysteinemia, antiphospholipid syndrome, paroxysmal nocturnal hemoglobinuria, renal cell carcinoma or other active malignancy, renal transplantation, trauma, postpartum, oral contraceptive use and sepsis syndrome [5][6][7][8][9][10]. Only seven previous cases of RVT complicating acute pyelonephritis or renal and perirenal abscesses have been described [1].…”

Section: Discussionmentioning

confidence: 99%

Renal vein thrombosis complicating severe acute pyelonephritis with renal abscesses and associated bacteraemia caused by extended-spectrum beta-lactamase producing Escherichia coli

et al. 2018

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Acute pyelonephritis might be complicated by the formation of renal and perirenal abscesses and very rarely by renal vein thrombosis, which is a life-threatening condition. The main causative agents of acute pyelonephritis are enterobacteriaceae with the incidence of extended-spectrum beta-lactamase (ESBL)-producing strains increasing worldwide. We present the case of a 71-year-old Greek man with history of diabetes mellitus and recent hospitalization, who suffered from severe pyelonephritis with renal abscesses formation and associated bacteraemia caused by ESBL-producing Escherichia coli, complicated by extensive thrombosis of the ipsilateral renal vein and its branches, protruding also in the inferior venal cava. Our patient was effectively treated with anticoagulants and targeted antibiotic therapy, respectively, consisted of low molecular weight heparin transitioned to oral acenocoumarol for 3 months and 2-week course of intravenous meropenem followed by oral fosfomycin for additional 3 weeks as quidded by clinical and computed tomographic follow-up. In conclusion, in complicated urinary infections, caused by ESBL-producing enterobacteriaceae, oral fosfomycin might represent an effective option for step-down therapy of carbapenems, allowing the shortness of the duration of patient's hospitalization and carbapenem use.

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“…The localization was the right ovarian vein in 54% of reported cases, 3,5-8,10,11,15,16,18,20,23-28,30-32,35,37,38,40-56,60-66, 69,71-74,76-78,82,86,89,90-94,96-98,102,107,108,111,115,119,123,125,126,128-131, 134-136,138,140,141,146,149 the left in 37% 4,14,19,21,29,34,39,57,67,70,73,80,83,93,120,121,122,124,127,133,139,143,145 and both veins in 9%. 17,19,22,36,52,59,79,86,87,93,95,132,137,142 Extension of thrombus in inferior vena cava (IVC) was observed in 81 cases, 5,6,9,11,12,16,18,20,[22][23][24]…”

Section: Diagnosis (Table 2)mentioning

confidence: 99%

“…Unfractionated heparin (UFH) or low molecular weight heparin (LMWH) was initiated in 70% of the cases and subsequently bridging to vitamin K antagonists (VKAs) in 40%. 4,7,9,10,12,14,17,19,21,[23][24][25][26][27][28]30,34,36,39,[42][43][44][45][46]48,51,55,59,60,64,65,67,73,74,79,82,89,91,96,98,99,102,105,106,109,115,118,120,121,122,129,…”

Section: Diagnosis (Table 2)mentioning

confidence: 99%

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Ovarian Vein Thrombosis

Kanellopoulou¹

2022

HJOG

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Ovarian vein thrombosis (OVT) is a rare type of venous thromboembolism most common diagnosed in the postpartum period and peaking around 2-6 days after delivery. Clinical symptoms are not specific including fever and abdominal pain and the right ovarian vein is more frequently involved (70-80% of cases). The diagnosis of OVT is a clinical challenge because there are multiple other conditions that can present similarly, including ovarian torsion, tubo-ovarian abscess, pelvic inflammatory disease, puerperal endometritis, appendicitis, inflammatory bowel disease and pyelonephritis. Ultrasound Doppler is the first-line imaging; however, most cases are confirmed with computed tomography or magnetic resonance imaging. Mortality related to ovarian vein thrombosis is low due to the combination treatment of broad-spectrum antibiotics and anticoagulation. Extension of thrombus to inferior vena cava or renal veins and rarely pulmonary embolism could also occur. OVT is actually a type of deep vein thrombosis that could be life-threatening however mortality is low due to the combination treatment of broad-spectrum antibiotics and anticoagulation. Anticoagulant treatment duration of 3 to 6 months has been recommended like typical cases of venous thromboembolism.

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Left ovarian and renal vein thrombosis after emergency postpartum hysterectomy

Cited by 3 publications

References 2 publications

Incidental finding of bilateral ovarian and renal veins thromboses post cesarean hysterectomy complicated by ureteric injury

Incidental finding of bilateral ovarian and renal veins thromboses post cesarean hysterectomy complicated by ureteric injury

Renal vein thrombosis complicating severe acute pyelonephritis with renal abscesses and associated bacteraemia caused by extended-spectrum beta-lactamase producing Escherichia coli

Ovarian Vein Thrombosis

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