[Pelvic thrombosis and uterine fibroids]

The association of thrombosis with an abdomino-pelvic mass should suggest that there is a malignant tumour present, and aetiology must be explored. All the same it is not possible to exclude a benign mass as the cause of the thrombosis. The anatomy of the blood vessels in this region make it more likely that the phlebitis will be on the left side. As far as the physiopathology is concerned the pressure on the vessels is associated probably with an increase in fibrous tissue, and perhaps a local excretion of tissue thromboplastin. The principal complications are: pulmonary embolus, or gangrene of the leg as a primary complication and also as a secondary post-phlebitic complication. Treatment with Heparin prescribed in every case in the correct doses. When the thrombosis is recent and threatening direct surgery may avoid the short and long term consequences. If thrombectomy is not indicated urgently surgery can be postponed unless the tumour is growing rapidly. It is important to avoid migration of the clot during the operation, and this is best done by putting a temporary clip on the vena cava which will avoid the serious vascular consequences after phlebitis and surgery.