Partial right gonadal vein thrombosis after uterine fibroid embolization

Gonadal vein thrombosis (GVT) is a very rare complication of uterine fibroid embolization. The risk factors for GVT include pregnancy, especially after caesarean-section, oral contraceptive use, underlying malignancy, any pelvic surgery including embolization procedures, pelvic inflammatory disease, inflammatory bowel disease and idiopathic causes. We report a case of a patient who underwent extensive uterine fibroid embolization and presented to the Emergency Department within twenty-four hours, with fever, and severe abdominal pain. Computed tomography of the abdomen and pelvis with intravenous (IV) contrast confirmed a partial right gonadal vein thrombosis. After extensive work up, and no alternative causes found, a diagnosis of procedure related GVT was made. After review of the literature and discussion with hematology consultants, she was started on anticoagulant therapy. Her symptoms resolved and she remained on anticoagulation for a duration of three months.