Departments of Obstetrics, Weifang People's Hospital, First Affiliated Hospital of Weifang Medical College, Weifang, Shandong, China.
Departments of General Surgery, Weifang People's Hospital, First Affiliated Hospital of Weifang Medical College, Weifang, Shandong, China.
Medicine (Baltimore). 2023 Aug 11;102(32):e34711. doi: 10.1097/MD.0000000000034711.
Postpartum ovarian vein thrombosis (POVT) is a rare disease, and could cause severe complications if ignored. We report a case of POVT, including the patient clinical features, diagnostic methods, treatment, and follow-up results.
A 30-year-old Asian woman was admitted to our hospital because of spontaneous abortion. After the miscarriage, she presented with fever and right lower abdominal pain. A physical examination revealed abdominal tenderness in the right lower quadrant with a palpable mass. Laboratory tests showed leucocytosis and elevated C-reactive protein. Abdominal ultrasound (US) and computed tomography revealed right ovarian vein thrombosis (OVT). The patient was treated with systemic anticoagulation and antibiotics and was discharged 22 days later on a regimen of an oral anticoagulant. 1.5 months after discharge, an US with a color Doppler examination showed no OVT.
A high index of suspicion is required in cases of abdominal pain and fever after delivery, especially if unresponsive to antibiotics. It should be differentiated from acute appendicitis, accessory abscess, endometritis, ovarian torsion, and other acute abdominal diseases. For a POVT case with a definite diagnosis, drug treatment may be effective enough.
产后卵巢静脉血栓形成（POVT）是一种罕见的疾病，如果忽视它可能会导致严重的并发症。我们报告了一例 POVT 病例，包括患者的临床特征、诊断方法、治疗和随访结果。
一名 30 岁的亚洲女性因自然流产而入院。流产后，她出现发热和右下腹痛。体格检查显示右下腹有压痛，并可触及肿块。实验室检查显示白细胞增多和 C 反应蛋白升高。腹部超声（US）和计算机断层扫描显示右侧卵巢静脉血栓形成（OVT）。患者接受全身抗凝和抗生素治疗，22 天后出院，继续口服抗凝剂治疗。出院后 1.5 个月，彩色多普勒超声检查显示无 OVT。
对于产后腹痛和发热的病例，需要高度怀疑，特别是如果对抗生素治疗无反应。应与急性阑尾炎、附件脓肿、子宫内膜炎、卵巢扭转和其他急性腹部疾病相鉴别。对于明确诊断的 POVT 病例，药物治疗可能已经足够有效。
