ovarian vein thrombosis

Ovarialvenenthrombose
beidseits - links umspült
Wikipedia • CC BY-SA 4.0
Ovarialvenenthrombose
beidseits - links umspült
Wikipedia • CC BY-SA 4.0
Ovarialvenenthrombose
rechts in der Computertomographie nach Hysterektomie mit kompliziertem Verlauf und Revision.
Wikipedia • CC BY-SA 3.0
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdomen axial view shows postpartum uterus. A thrombosis noted in right ovarian vein and in right IVC. Both renal veins appear normal. No fluid or air collections. Right renal hydronephrosis. No bowel obstruction.
www.eurorad.org • CC by-nc-sa-4.0
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdomen, axial view shows enlarged left ovary with thrombosis involving left ovarian vein extending to left renal vein. No air/fluid collections. Normal right ovary. Abdominal organs are normal. No hydroureteronephrosis. No bowel obstruction.
www.eurorad.org • CC by-nc-sa-4.0
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdomen sagittal view show bilateral OVT with left side cordlike structure extending from ovaries to renal vein. Inflammatory soft tissue thickening in left ovarian vein till aortic bifurcation. No free fluid. No lymphadenopathy.
www.eurorad.org • CC by-nc-sa-4.0
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdomen coronal views show bilateral OVT with cordlike structure extending from ovaries to renal vein. Inflammatory soft tissue thickening in left ovarian vein till aortic bifurcation. No free fluid. No lymphadenopathy.
www.eurorad.org • CC by-nc-sa-4.0
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdominal, axial view, shows heterogenous enhanced soft tissue mass in the left iliac fossa adjacent to left adnexa. Other abdominal organs, uterus and right ovary are normal. No free fluid or air.
www.eurorad.org • CC by-nc-sa-4.0
Umspülter
Thrombus in der rechten Ovarialvene in der Computertomographie.
Wikipedia • CC BY-SA 3.0
Ovarialvenenthrombose
in der Computertomographie. Man erkennt bei der Patientin ca. 3 Wochen nach Geburt ihres Kindes auf der linken Seite einen umspülten Thrombus in den noch sehr weiten Ovarialvenen. Der Uterus ist noch vergrößert. Coronare Rekonstruktion.
Wikipedia • CC BY-SA 3.0
Ovarialvenenthrombose
rechts in der Computertomographie nach Hysterektomie mit kompliziertem Verlauf und Revision.
Wikipedia • CC BY-SA 3.0
Thrombosis in
the left renal vein associated with dilation.
Wikipedia • CC BY-SA 3.0
Ovarialvenenthrombose
rechts in der Computertomographie nach Hysterektomie mit kompliziertem Verlauf und Revision.
Wikipedia • CC BY-SA 3.0
Ovarian vein
thrombosis • Post partum right ovarian vein thrombosis (thrombophlebitis) - Ganzer Fall bei Radiopaedia
O'Donnell C, Post partum right ovarian vein thrombosis (thrombophlebitis). Case study, Radiopaedia.org (Accessed on 06 Jan 2023) https://doi.org/10.53347/rID-45709 • CC by-nc-sa 3.0 (modified)
Colonic
diverticulitis • Complicated sigmoid diverticulitis with fistulation to bladder and vagina - Ganzer Fall bei Radiopaedia
Shah, V. Complicated sigmoid diverticulitis with fistulation to bladder and vagina. Case study, Radiopaedia.org. (accessed on 31 Oct 2022) https://doi.org/10.53347/rID-88707 • CC by-nc-sa 3.0 (modified)
Case reports
of imaging of postpartum ovarian vein thrombosis. CE-CT abdomen sagittal view shows postpartum uterus. A thrombosis noted in right ovarian vein and in right IVC. Both renal veins appear normal. No fluid or air collections. Right renal hydronephrosis. No bowel obstruction.
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

Ovarian vein thrombosis (actually most often thrombophlebitis) occurs most commonly in postpartum patients and can result in pulmonary emboli. A presentation is usually with acute pelvic pain in the postpartum period, then termed puerperal ovarian vein thrombosis or postpartum ovarian vein thrombosis.

Epidemiology

The estimated incidence of postpartum ovarian vein thrombosis is ~1:600-1:2000 deliveries .

Clinical presentation

The dominant symptom of clinically significant ovarian vein thrombosis is pain in the lower abdomen / right lower quadrant pain and fever, which usually appears approximately ten days postpartum with no response to antibiotic treatment. There may occasionally be a palpable mass felt in the right iliac fossa.

Pathology

Location: laterality
  • in ~80-90% of cases, the right ovarian vein is involved, possibly due to retrograde flow in the left vein preventing stasis and ascending infection
  • ~14% of cases can have bilateral involvement
  • ~6% of cases involve the left ovarian vein only

Radiographic features

Ultrasound 

May be difficult if there is overlying bowel gas and the ovarian vein may not be identified in every case .

  • tubular/serpiginous hypoechoic structure in the adnexa adjacent to the ovarian artery
  • if the ovarian vein is identifiable, the absence of Doppler flow can be a diagnostic feature
CT
  • tubular structure with an enhancing wall and low-attenuation thrombus in the expected location of the ovarian vein

Treatment and prognosis

Appropriate treatment consists of a combination of anticoagulation and antibiotics. However, mortality rates of up to 5% have been observed, making the diagnosis an important one to consider in the postpartum patient.

Complications

Differential diagnosis

Considerations include:

Siehe auch:
und weiter:
Assoziationen und Differentialdiagnosen zu Ovarialvenenthrombose:
Vena ovarica
 
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Nussknacker-Syndrom
 
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Varicocele
der Vena ovarica
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Appendizitis
 
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Ovarialvenenthrombose
rechts
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