Arora Ena, Mujumdar Vaidehi, Martin Alexander, Tuli Sandeep
Department of Obstetrics and Gynecology, Icahn School of Medicine at Mount Sinai, New York, USA.
Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, USA.
Eur J Case Rep Intern Med. 2022 May 16;9(5):003351. doi: 10.12890/2022_003351. eCollection 2022.
Ovarian vein thrombosis (OVT) is a relatively rare, but serious disease more commonly seen in puerperal patients. In the postpartum period, there is an unequal incidence of OVT in women with vaginal delivery (0.18%) and caesarean section (2.0%). OVT is usually associated with other conditions like pelvic inflammatory disease, malignant tumours, sepsis, enteritis, and recent pelvic or abdominal surgery. The incidence of idiopathic OVT is extremely rare and only a few cases have been reported to date in healthy patients with unknown aetiology. Patients with OVT present with abdominal pain, nausea, vomiting, fever or abdominal mass. Complications of OVT include pulmonary embolism, ovarian infarction, sepsis and death. CT scanning of the abdomen provides reliable evidence for the diagnosis of idiopathic OVT. Thrombus in most patients with idiopathic OVT is located in the right ovarian vein. This may be due to the longer length of the right ovarian vein, right shift of the uterus and relative insufficiency of the right ovarian vein valve. Treatment of OVT includes systemic anticoagulation which will achieve resolution of symptoms and prevent life-threatening complications. Our case report documents a non-puerperal patient who underwent hysterectomy a year before presenting to the ED with complaints of diarrhoea and found to have OVT on a CT scan. Our case brings attention to the fact that OVT can occur outside the puerperium and might present as a rare complication of minimally invasive surgeries for endometrial cancer. Furthermore, we posit that OVT in the non-puerperal patient may be a separate clinical entity.
Ovarian vein thrombosis (OVT) can occur outside the puerperium and might present as a rare complication of minimally invasive surgeries.OVT should be included in the differential diagnosis of a non-puerperal postoperative woman presenting with vague abdominal symptoms.Duration of anti-coagulation varies from case to case. More research is needed to determine its exact duration.
卵巢静脉血栓形成（OVT）是一种相对罕见但严重的疾病，更常见于产后患者。在产后期，经阴道分娩的女性发生OVT的发生率为0.18%，剖宫产女性为2.0%，两者发生率不相等。OVT通常与其他疾病相关，如盆腔炎、恶性肿瘤、败血症、肠炎以及近期的盆腔或腹部手术。特发性OVT的发生率极其罕见，迄今为止仅有少数病因不明的健康患者的病例报道。OVT患者表现为腹痛、恶心、呕吐、发热或腹部肿块。OVT的并发症包括肺栓塞、卵巢梗死、败血症和死亡。腹部CT扫描为特发性OVT的诊断提供可靠依据。大多数特发性OVT患者的血栓位于右侧卵巢静脉。这可能是由于右侧卵巢静脉较长、子宫右移以及右侧卵巢静脉瓣膜相对不足所致。OVT的治疗包括全身抗凝，这将缓解症状并预防危及生命的并发症。我们的病例报告记录了一名非产后患者，该患者在因腹泻就诊于急诊科前一年接受了子宫切除术，CT扫描发现患有OVT。我们的病例提醒人们注意，OVT可发生在产褥期之外，可能是子宫内膜癌微创手术的罕见并发症。此外，我们认为非产后患者的OVT可能是一种独立的临床实体。
卵巢静脉血栓形成（OVT）可发生在产褥期之外，可能是微创手术的罕见并发症。对于出现模糊腹部症状的非产后术后女性，应将OVT纳入鉴别诊断。抗凝持续时间因病例而异。需要更多研究来确定其确切持续时间。
