Ovarian Vein Thrombosis

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.