Postpartum ovarian vein thrombosis presenting as ureteral obstruction

Kolluru, Anuradha; Lattupalli, Rakesh; Kanwar, Manreet; Behera, Deepak; Kamalakannan, Desikan; Beeai, Muhammed K

doi:10.1136/bcr.03.2010.2863

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…Ovarian vein thrombophlebitis (OVT) is a relatively rare disorder associated with multiple pelvic conditions, including recent childbirth, pelvic inflammatory disease, malignancy, chemotherapy, and pelvic surgery (56). Among women of childbearing age, it is more commonly seen in the immediate postpartum period, with a reported incidence ranging from one in 600 to one in 2000 deliveries, and it is much more common after cesarean delivery than after vaginal delivery (56). It is currently thought to arise from bacterial seeding as a result of endometritis, resulting in infectious thrombophlebitis.…”

Section: Ovarian Vein Thrombophlebitismentioning

confidence: 99%

“…This distribution has been ascribed to the more common dextrotorsion of the gravid uterus compressing the right ovarian vein as it crosses the pelvic brim. In addition, the right ovarian vein is longer than the left, with many valves that may contribute to the thrombus formation (56). Moreover, left gonadal vein flow has been shown to be retrograde during pregnancy, preventing upstream bacterial seeding.…”

Section: Ovarian Vein Thrombophlebitismentioning

confidence: 99%

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Imaging of Pregnancy-related Vascular Complications

et al. 2017

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Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy. The authors review relevant normal physiologic changes of pregnancy, pathophysiologic changes, and imaging features of vascular conditions that can manifest in conjunction with pregnancy. Particular attention is given to pertinent imaging information that radiologists should provide to referring clinicians to optimally affect the management of pregnant patients as well as women in the peripartum and postpartum stages. Among the complications discussed are preeclampsia; hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome; spontaneous coronary artery dissection; placental abruption; amniotic fluid embolism and acute pulmonary embolism; dural venous sinus thrombosis; ovarian vein thrombophlebitis; vasa previa; uterine arteriovenous malformations; heritable aortopathies; and hereditary hemorrhagic telangiectasia. To help radiologists avoid the use of unnecessary ionizing radiation in pregnancy, imaging examination selection and optimization are also reviewed. Radiologists should be familiar with the physiologic changes of pregnancy, radiation risks during gestation, and pregnancy-related vascular complications to improve imaging examination selection, diagnosis, and clinical management. RSNA, 2017.

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Section: Ovarian Vein Thrombophlebitismentioning

confidence: 99%

Section: Ovarian Vein Thrombophlebitismentioning

confidence: 99%

Imaging of Pregnancy-related Vascular Complications

et al. 2017

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“…Various studies have shown that POVT can lead to sepsis, ovarian infarction or, with extension of the clot into the renal veins and inferior vena cava, ureteral obstruction, hydronephrosis or renal failure . Pulmonary embolism has been a reported complication in 33% of cases with a mortality rate of 4.4% .…”

Section: Complicationsmentioning

confidence: 99%

Postpartum ovarian vein thrombosis

Dougan

Phillips

Harley

et al. 2016

The Obstetric & Gynaecologis

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Key content Postpartum ovarian vein thrombosis (POVT) is a rare but potentially fatal condition. Symptoms up to 4 weeks postpartum often include vague abdominal pain and pyrexia. A high index of suspicion is required to make the diagnosis. As there is no consensus regarding management, a multidisciplinary approach is advised. Learning objectives Recognise the symptoms and signs of POVT and formulate a differential diagnosis. Recognise the importance of imaging in confirming the diagnosis and involvement of the multidisciplinary team to plan management. Understand that conservative management with low‐molecular‐weight heparin is the first‐line treatment, and understand the situations that may require vena caval filter insertion or surgical intervention. Ethical issues How can we counsel women about risks of conservative and surgical management of this condition when there is no consensus for this management? Should women who have had an ovarian vein thrombosis in a previous pregnancy be counselled toward avoiding future pregnancy?

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“…Such pelvic or abdominal venous thrombophlebitis is a rare but serious postpartum complication. This disease is characterized by inflammation or thrombosis of a pelvic or abdominal vein, and patients typically present with fever and abdominal pain within the first postpartum week [ 4 ]. Almost all previous reports have been regarding ovarian vein thrombophlebitis.…”

Section: Discussionmentioning

confidence: 99%

Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period

Nakamura

Nakanishi

Kubota

et al. 2018

Case Reports in Obstetrics and Gynecology

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Venous thrombophlebitis is an uncommon cause of fever and lower abdominal pain during the early postpartum period. It mostly occurs in the right ovarian vein, and computed tomography (CT) is useful for diagnosis. We present a case of thrombophlebitis of the renal capsular vein. A 27-year-old postpartum woman presented with right lower abdominal pain and fever unresponsive to antibiotics. Contrast CT showed a ring-enhancing mass in the right retroperitoneum, which was distinct from the right ovarian vein. Exploratory laparoscopy revealed a retroperitoneal hematoma and normal appendix. Reconstruction of CT images revealed that the mass was connected to the right renal capsular vein. Anticoagulation therapy improved the patient's symptoms. Postpartum thrombophlebitis can occur at locations other than the ovarian vein, such as the renal capsular vein. If a retroperitoneal mass is discovered during puerperium, a thorough investigation of the mass's continuity with surrounding vessels is essential to avoid unnecessary surgery.

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Postpartum ovarian vein thrombosis presenting as ureteral obstruction

Cited by 5 publications

References 11 publications

Imaging of Pregnancy-related Vascular Complications

Imaging of Pregnancy-related Vascular Complications

Postpartum ovarian vein thrombosis

Thrombophlebitis of the Right Renal Capsular Vein during the Early Postpartum Period

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