DEEP VEINS THROMBOSIS MIMICKING AN INFECTION IN A POSTPARTUM WOMAN
Keywords:Ovarian vein thrombosis, inferior cava inferior, postpartum
Ovarian Vein Thrombosis (OVT) is a rare, yet a serious complication, especially if it extends to an inferior cava vein. OVT can occur at any stage, but it mostly occurs during the postpartum period. Diagnosis is not often immediately apparent, and many other diseases can mimic this condition. Exclusion of any infectious etiologic cause in a postpartum patient with fever is the first step in establishing an OVT diagnosis. It can be accurately diagnosed by appropriate non-invasive investigations to enable early therapy with anticoagulants and intravenous antibiotics, which are the mainstay of treatment. We present a case of a 38-year-old female in the postpartum period who was diagnosed with right OVT reaching the inferior vein cava after a vaginal delivery. She was treated with intravenous antibiotic and anticoagulant therapy and had a successful recovery after repeated image six months after, showing complete resolution of thrombus.
Al-toma A, Heggelman G.F, Kramer M.H.H (2003). Postpartum ovarian vein thrombosis: report of a case and review of the literature. Netherlands Journal of Medicine. Vol. 61, no.10: 334–336
Austin OG (1956). Massive thrombophlebitis of the ovarian vein thrombosis. Am J Obstet Gynecol.; 72:428–429
Bates S.M, Ginsberg J.S (2002). How we manage venous thromboembolism during pregnancy. Blood. 15.;100(10):3470-3478
Calderwood C.J. Jamieson R, Greer I.A (2007). Gestational related changes in the deep venous system of the lower limb on light reflection rheography in pregnancy and the puerperium. Clinical Radiology. Vol 62. No 12. 1174-1179
Clarke C.S, Harlin S.A (1999). Puerperal ovarian thrombosis with extension into vena cava. Am Surg .65:147-150
Dougan C, Phillips R, Harley I, et al., (2016). Postpartum ovarian vein thrombosis. 2016.Obstetr, Gynaecology. 18, 291-299
Derrick FC Jr, Rosenblum RR, Lynch KM Jr (1997). Pathological association on the right ureter and right ovarian vein. J Urol, 97:633-640
Dunnihoo D.R, Gallaspy R.B, Wise R.B et al., (1991). Postpartum ovarian vein thrombophlebitis: a review. Obstetr and Gynecol Survey.Vol. 46, no. 7: 415–427
Greer. I.A. Thomson A. J (2001). Management of venous thromboembolism in pregnancy. Best Pract Res Clin Obstetr Gynaecol.;15:583-603
Harris K, Mehta S, Iskhakov E, et al., (2012). Ovarian vein thrombosis in nonpregnant women: an overlooked diagnosis. Ther Adv Hematol,3:325-328
Harun A, Sibel A, Sebahattin C et al., (2014). Postpartum ovarian vein and inferior vena cava thrombosis. Case Reports in Medicine. http://dx.doi.org/10.1155/2014/609187
Jenayah A.A, Saoudi S, Boudaya F, et al (2015). Ovarian vein thrombosis. Pan Afr Med J. 21:251
Kearon C (2003). Diagnosis of pulmonary embolism. CMAJ. Jan 168: 183-194
Klima D.A, Snyder T.E (2008). Postpartum ovarian vein thrombosis. Obstetr, Gynaecology.111. 431-435
Khlifi A, Kebaili S, Hammami M, et al., (2010). Postpartum ovarian vein thrombophlebitis: report of a case and review of the literature. North Am J Med Sci,2:389-391
Kominiarek MA, Hibbard JU (2006). Postpartum ovarian vein thrombosis: an update. Obstet Gynecol Surv.;61:337–342.
Kubik-Huch RA, Hebisch G, Huch R, et al., (1999). Role of duplex colour Doppler ultrasound, computed tomography, and MR angiography in the diagnosis of septic puerperal ovarian vein thrombosis. Abdominal Imaging.24(1).85-91
Nagayama M, Watanabe Y, Okumura A et al., (2002). Fast MR imaging in obstetrics. Radiographics. 22(3):563-580
Ortin Font X, Ugarriza A, Espax R. M. et al (2005). “Postpartum ovarian vein thrombosis ». Thrombosis and Haemostasis. Vol 93. No.5. 1004-1005
Plastini T, Henry D, Dunleavy K (2017). Ovarian vein thrombosis: to treat or not to treat? Blood Avd. 1:1120-1123
Quarello E, Desbriere R, Hartung O, et al., (2004). Postpartum ovarian veins thrombophlebitis: report of 5 cases and review of the literature. J Gynecol Obstet Biol Repro. 33:430-440
Roberts S. Ch, Dunn A. M (2019). Postpartum inferior vena cava thrombosis treated by endovascular suction thrombectomy utilizing veno-venous extracorporeal circulation. Journal Baylor University Medical Center. Volume 32, Issue 4, 554-556
Rottenstreich A, Da’as N, Kleinstern G at al (2016). Pregnancy and non-pregnancy related ovarian vein thrombosis: Clinical course and outcome. Thromb Res.;146;84-88
Salomon O, Dulitzky M, Apter S. (2010). New observations in postpartum ovarian vein thrombosis: experience of single center. Blood Coagul Fibrinolysis;21 (1):16-19
Savader S.J, Otero R.R, Savader L (1988). Puerperal ovarian vein thrombosis: Evaluation with CT, US, and MRI. Radiology, vol 167. No 3. 637-639
Scarsbrook A.F, Evans A.L, Owen A.R, Gleeson F.V (2006). Diagnosis of suspected venous thromboembolic disease in pregnancy. Clin Radiology. Jan 61:1-12
Sorbi F, Mannini L, Aldinucci M, et al., (2016). Ovarian Vein Thrombosis Presenting as Acute Abdomen in Puerperium. J ClinDiagn Res.;10(2): QD03-4.
Togan T, Turan H, Cifci E, Çiftci C (2015). Ovarian and Renal Vein Thrombosis: A Rare Cause of Fever Outer the Postpartum Period. Case Rep Obstet Gynecol.:817862.
Wysokinska E.M, Hodge D, Mc Bane II R.D (2006). Ovarian vein thrombosis: Incidence of recurrent venous thromboembolism and survival, Thrombosis and Haemostasis, vol. 96, no.2, pp:126–131
How to Cite
This work is licensed under a Creative Commons Attribution 4.0 International License.
The author is the copyright holder. Distribution license: CC Attribution 4.0.