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Massive septic pelvic thrombophlebitis

K P Magee1, J D Blanco, J M Graham

  • 1Department of Obstetrics, Gynecology, and Reproductive Sciences, Lyndon B. Johnson General Hospital, University of Texas Medical School at Houston.

Obstetrics and Gynecology
|October 1, 1993
PubMed
Summary
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Septic pelvic thrombophlebitis, a serious complication of endometritis, can extend beyond the pelvis. This case highlights successful treatment and resolution of extensive thrombi in a postpartum patient.

Area of Science:

  • Obstetrics and Gynecology
  • Vascular Surgery
  • Infectious Diseases

Background:

  • Septic pelvic thrombophlebitis (SPT) is a rare but serious complication of postpartum endometritis.
  • It involves the formation of infected thrombi in pelvic veins, commonly the uterine and ovarian veins.
  • These thrombi can potentially extend into larger vessels like the inferior vena cava.

Observation:

  • A 19-year-old woman, gravida 2, developed SPT following vaginal delivery.
  • The thrombophlebitis extended from the right ovarian vein to the diaphragm and down to the femoral vein.
  • This extensive vascular involvement is unusual for SPT.

Findings:

  • The patient received a combination of heparin and antibiotics for treatment.
  • The treatment regimen led to successful resolution of the extensive thrombus.

Related Experiment Videos

  • The patient was discharged on long-term oral anticoagulants.

    • Implications:

    • Septic pelvic thrombophlebitis is not confined to pelvic and lower abdominal vessels.
    • Early diagnosis and aggressive treatment, including anticoagulation and antibiotics, are crucial for managing extensive SPT.
    • This case underscores the importance of considering widespread vascular involvement in severe cases of postpartum SPT.