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Postpartum ovarian vein thrombosis causing severe hydronephrosis.
Shelly Welch Holmström1, Brian P Barrow
1From the University of South Florida, Tampa, Florida.
Obstetrics and Gynecology
|January 23, 2010
Summary
Postpartum ovarian vein thrombosis is rare and can present with severe pain. Early consideration of ovarian vein thrombosis is crucial for timely diagnosis and treatment in postpartum women.
Area of Science:
- Obstetrics and Gynecology
- Vascular Surgery
- Radiology
Background:
- Ovarian vein thrombosis (OVT) is a rare but serious postpartum complication.
- Delayed diagnosis of OVT is common due to a broad differential diagnosis for pelvic and abdominal pain.
- This case highlights an atypical presentation of postpartum OVT.
Observation:
- A postpartum woman presented with severe right lower quadrant pain and right thigh numbness on postpartum day 3.
- Computed tomography revealed right hydronephrosis and pyelocalyceal rupture, suggesting right ovarian vein thrombosis.
- The patient received a right nephrostomy tube and anticoagulation therapy.
Findings:
- Post-treatment antegrade nephrostography demonstrated unobstructed flow from the ureter to the bladder.
- Successful management of the hydronephrosis and suspected OVT was achieved.
- The patient recovered without evidence of obstruction after four weeks.
Implications:
- Ovarian vein thrombosis should be included in the differential diagnosis for postpartum women with abdominal or pelvic pain.
- Prompt recognition and management of OVT can prevent severe complications like renal compromise.
- This case underscores the importance of considering vascular causes in postpartum pain presentations.
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