1
|
Yii E, Yao H, Yii M. Choosing safe and effective anticoagulation to treat idiopathic ovarian vein thrombosis: using first principles of deep vein thrombosis management to treat a rare diagnosis: a case report and review of the literature. J Med Case Rep 2023; 17:147. [PMID: 37081562 PMCID: PMC10120227 DOI: 10.1186/s13256-023-03876-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 03/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Ovarian vein thrombosis (OVT) often presents in the post-partum period and is associated with significant complications including inferior vena cava extension, pulmonary embolism, sepsis, and renal obstruction. Idiopathic OVT is rare, and no consensus has been agreed upon regarding its diagnosis and management. This case presents a patient who was diagnosed with idiopathic OVT and was treated with apixaban. A literature review was performed collating reported cases of idiopathic OVT to form a recommendation regarding optimal management and follow up. CASE PRESENTATION A 42-year-old Chinese woman presenting with right lower quadrant pain underwent a CT abdomen after urinary tract obstruction was excluded on ultrasound. She was subsequently diagnosed with an idiopathic 35 mm ovarian vein thrombus (OVT) given no history of primary coagulopathy nor secondary aetiology. A literature review was performed collating 18 case reports with method of diagnosis and management summarized. Treatment alternatives included low molecular weight heparin, warfarin, rivaroxaban and apixaban. Most were diagnosed after work up for suspected renal calculus or appendicitis. Follow up imaging was performed from between 6 weeks to 6 months after initiation of anticoagulation. CONCLUSIONS Direct oral anticoagulants were an effective treatment for OVT, however warfarin should be commenced in those suspected of antiphospholipid syndrome awaiting confirmation or exclusion of the diagnosis.
Collapse
Affiliation(s)
- Erwin Yii
- Department of Vascular Surgery, Eastern Health, Box Hill, VIC, Australia.
| | - Hexiang Yao
- Healthbound Family Practice, Bentleigh East, VIC, Australia
| | - Ming Yii
- Department of Vascular Surgery, Monash Health, Clayton, VIC, Australia
| |
Collapse
|
2
|
Wang JJ, Hui CC, Ji YD, Xu W. Computed tomography diagnosed left ovarian venous thrombophlebitis after vaginal delivery: A case report. World J Clin Cases 2023; 11:896-902. [PMID: 36818636 PMCID: PMC9928707 DOI: 10.12998/wjcc.v11.i4.896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/21/2022] [Accepted: 01/12/2023] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Postpartum ovarian vein thrombophlebitis (POVT) is a rare but serious postpartum complication that affects mostly postpartum women. A high index of suspicion is required when faced with sudden postpartum abdominal pain.
CASE SUMMARY A 25-year-old healthy woman who accepted a vaginal delivery procedure suffered fever (temperature 39.6℃) one day after delivery, accompanied with left lower abdominal pain. Physical examination indicated mild tenderness in the left lower abdomen, accompanied with rebound pain. The patient was confirmed to have left ovarian venous thrombosis with inflammation after receiving a multi-detector row computed tomography scan.
CONCLUSION POVT is a rare and dangerous postpartum complication. A high index of suspicion is required for the occurrence of ovarian venous thrombosis when faced with postpartum abdominal pain and fever. Early application of Doppler ultrasound, computed tomography, magnetic resonance imaging and other auxiliary examinations is conducive to timely and accurate diagnosis of POVT, thus reducing maternal mortality.
Collapse
Affiliation(s)
- Jin-Jin Wang
- Department of Radiology, The Ninth People’s Hospital of Suzhou City, Suzhou 215200, Jiangsu Province, China
| | - Chu-Chu Hui
- Department of Ultrasound, The Ninth People’s Hospital of Suzhou City, Suzhou 215200, Jiangsu Province, China
| | - Yi-Ding Ji
- Department of Radiology, The Ninth People’s Hospital of Suzhou City, Suzhou 215200, Jiangsu Province, China
| | - Wei Xu
- Department of Emergency Medicine, The Ninth People’s Hospital of Suzhou City, Suzhou 215200, Jiangsu Province, China
| |
Collapse
|
3
|
Alsheef M, Abuzied Y, Alosaimi M, Altamimi A, Alwazna Q, Almahmood Q, AlBulushi NA, Almutair J, Zaidi ARZ, Gray J, Abu-Shaheen A. Clinical Characteristics and Management of Ovarian Vein Thrombosis: A Case Series. Front Cardiovasc Med 2022; 9:916920. [PMID: 35783843 PMCID: PMC9243581 DOI: 10.3389/fcvm.2022.916920] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Ovarian vein thrombosis (OVT) is an uncommon condition, occurring in ~1 in every 600–2,000 pregnancies. It is associated with various conditions, including thrombophilia, malignancy, sepsis, intra-abdominal and pelvic inflammatory conditions, pregnancy, and the postpartum period, and specific surgical interventions, particularly gynecological surgeries. Thus, this study aims to identify the associated factors for OVT and elaborate on the standard treatment strategies for its management. Methods Retrospective data collection was used. Our study consists of 18 patients diagnosed with OVT between 2005 and 2016; the data was collected from the Health Information Management system at King Fahad Medical City, Riyadh, Saudi Arabia using a standard format. Results Our study found that OVT involves the right ovarian vein more often than the left and mainly occurs in women during their postpartum period. These patients other associated factor included hypertension, diabetes, and a higher body mass index (BMI) of above 25 kg/m2. The most frequently presenting complaints were abdominal pain and fever. The most common treatment was the administration of enoxaparin (a low molecular weight heparin) for an average duration of one to three months, which resulted in a low recurrence rate of OVT. Conclusions Physicians should be vigilant for suspicion of OVT in female patients presenting with lower abdominal pain and fever in their postpartum period. Additionally, it is suggested to use low molecular weight heparin as initial therapy for OVT for one to three months, resulting in a high remission rate.
Collapse
Affiliation(s)
- Mohammed Alsheef
- Internal Medicine and Thrombosis, Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
- *Correspondence: Mohammed Alsheef
| | - Yacoub Abuzied
- Spinal Cord Injury Unit, Nursing Department, Rehabilitation Hospital, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Muteb Alosaimi
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Amer Altamimi
- Adult Hematology Department, Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Qusai Alwazna
- College of Medicine, Al-Imam Muhammad ibn Saudi Islamic University, Riyadh, Saudi Arabia
| | - Qusai Almahmood
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | - Jehan Almutair
- College of Medicine, AlMaarefa University, Riyadh, Saudi Arabia
| | | | - Jenny Gray
- Dentistry Administration, King Fahad Medical City, Riyadh, Saudi Arabia
- Jenny Gray
| | - Amani Abu-Shaheen
- Department of Scientific Writing, Research Center, King Fahad Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
4
|
Li W, Cao S, Zhu R, Chen X. Idiopathic ovarian vein thrombosis causing pulmonary embolism: case report and literature review. J Int Med Res 2021; 49:3000605211010649. [PMID: 34187208 PMCID: PMC8258764 DOI: 10.1177/03000605211010649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/25/2021] [Indexed: 11/26/2022] Open
Abstract
Ovarian vein thrombosis (OVT) is a rare medical disorder, which is most often found in the immediate postpartum period. OVT is rarely considered idiopathic. We report a case of idiopathic OVT with pulmonary embolism in a 33-year-old woman who presented with abdominal pain. Computed tomography and postoperative pathology confirmed the diagnosis of idiopathic OVT. To date, only 12 cases of idiopathic OVT have been reported. In this case report, we present a summary of these cases and a review of literature regarding management of idiopathic OVT.
Collapse
Affiliation(s)
- Wenrui Li
- Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Saisai Cao
- Department of Plastic Surgery, Peking University People’s Hospital, Beijing, China
| | - Renming Zhu
- Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xueming Chen
- Department of Vascular Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
5
|
Christy J, Jarugula D, Kesari K, Kunadi A. Idiopathic bilateral ovarian vein thrombosis. BMJ Case Rep 2021; 14:e238243. [PMID: 33622744 PMCID: PMC7903109 DOI: 10.1136/bcr-2020-238243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2021] [Indexed: 11/04/2022] Open
Abstract
Ovarian vein thrombosis (OVT) is a condition most commonly associated with malignancy, hypercoagulable disorders, pelvic surgery, trauma, inflammatory bowel disease and the postpartum period. Idiopathic bilateral OVT is extremely rare. We report the case of a 30-year-old African-American woman who presented with bilateral lower pelvic pain and nausea. She had no recent pelvic infections nor a personal or family history of malignancy or thrombophilia. Workup results for a hypercoagulable state was negative. A CT scan of the abdomen and pelvis revealed bilateral OVT. Treatment included novel oral anticoagulants or warfarin, with comparison studies showing a similar risk-benefit ratio. Repeat imaging is recommended after 40-60 days to determine the necessity for further anticoagulation. Emphasis is placed on starting anticoagulation early in order to reduce the risk of extension of the thrombus into the inferior vena cava, conversion to pulmonary embolism or increase in the risk of infection.
Collapse
Affiliation(s)
- Joshua Christy
- Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
| | - Divya Jarugula
- Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
| | - Kavitha Kesari
- Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
| | - Arvind Kunadi
- Internal Medicine, McLaren Regional Medical Center, Flint, Michigan, USA
| |
Collapse
|
6
|
Basit A, Kaur P, Villanueva DM, Tahir M, Sonnenschine M. Idiopathic Bilateral Ovarian Vein Thrombosis in a Non-Pregnant Healthy Patient: A Case Report and Review of the Literature. Cureus 2020; 12:e10111. [PMID: 33005529 PMCID: PMC7523547 DOI: 10.7759/cureus.10111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Ovarian vein thrombosis (OVT) is a potentially life-threatening condition, and it is typically related to the peripartum period; however, it is also associated with pelvic inflammatory disease, recent pelvic or abdominal surgery, inflammatory bowel disease, thrombophilia, malignancy, and sepsis. Idiopathic isolated OVT is rare and is usually presented as case reports in the medical literature. In this report, we present a case of bilateral OVT in a postmenopausal female with no identifiable risk factors and normal coagulation profile workup to highlight the importance of considering it as a differential diagnosis in female patients presenting with abdominal pain. Early identification can prevent potentially life-threatening complications. Management is often conservative, and the choice of anticoagulation is based on the patient’s medical conditions. In this particular scenario, the patient was managed with low molecular weight heparin (LMWH) and transitioned to direct oral anticoagulant (DOAC) before discharge.
Collapse
Affiliation(s)
- Abdul Basit
- Internal Medicine, Coney Island Hospital, Brooklyn, USA
| | | | | | - Muhammad Tahir
- Pathology, Case Western Reserve University School of Medicine, Cleveland, USA
| | | |
Collapse
|
7
|
da Silva Cunha M, Godinho AB, Botelho R, de Almeida JP. Postpartum septic pelvic thrombophlebitis after caesarean delivery: a case report. Case Rep Womens Health 2018; 17:5-7. [PMID: 29594006 PMCID: PMC5869062 DOI: 10.1016/j.crwh.2018.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 02/09/2018] [Accepted: 02/27/2018] [Indexed: 11/27/2022] Open
Abstract
Septic pelvic thrombophlebitis is a rare puerperal complication. It is an important differential diagnosis of postpartum fever and abdominal pain and although the condition is well known its diagnosis can be challenging. We report a case of a 41-year-old woman with fever and right abdominal pain three days after an uncomplicated caesarean delivery. Clinical, laboratory and imaging exams were unremarkable and the patient was treated for endometritis. In the absence of improvement despite an antibiotic adjustment, a clinical diagnosis of septic pelvic thrombophlebitis was made, and the patient presented a good response to anticoagulation in conjunction with broad-spectrum antibiotic therapy.
Caesarean delivery is a risk factor for septic pelvic thrombophlebitis (SPT). SPT is frequently misdiagnosed. SPT resolves after systemic anticoagulation. Clinical suspicion is the most important for the diagnosis.
Collapse
Affiliation(s)
- Margarida da Silva Cunha
- Department of Gynecology and Obstetrics - Centro Hospitalar de Setúbal, EPE, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal
| | - Ana Beatriz Godinho
- Department of Gynecology and Obstetrics - Centro Hospitalar de Setúbal, EPE, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal
| | - Rosário Botelho
- Department of Gynecology and Obstetrics - Centro Hospitalar de Setúbal, EPE, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal
| | - José Pinto de Almeida
- Department of Gynecology and Obstetrics - Centro Hospitalar de Setúbal, EPE, Rua Camilo Castelo Branco, 2910-446 Setúbal, Portugal
| |
Collapse
|
8
|
Abstract
Ovarian vein thrombosis (OVT) is a rare medical disorder most often diagnosed in the peripartum period and maybe associated with other risk factors for thrombosis. Rarely, OVT is considered idiopathic. It occurs in the right ovarian vein alone in two-thirds of patients. In this report, we present a case of idiopathic and bilateral OVT in a 35-year-old woman who presented with 2-day history of left flank pain. Duplex ultrasound imaging and computed tomography confirmed the diagnosis. Oral anticoagulation achieved a favorable outcome.
Collapse
|
9
|
Toman E, Beaven A, Balogun M, Porter K. Ovarian vein thrombosis in a polytrauma patient. BMJ Case Rep 2015; 2015:bcr-2015-213071. [PMID: 26682843 DOI: 10.1136/bcr-2015-213071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A young mother presented to a major trauma centre following a road traffic collision. Her admission CT traumagram demonstrated liver and renal lacerations, spinal and pelvic fractures with no abnormalities of the ovarian veins. Her inpatient course was uncomplicated other than a sustained, isolated raised C reactive protein. CT of the abdomen 1 week after injury demonstrated stable solid organ injuries and the additional, unexpected finding of a right ovarian vein thrombosis (OVT). A pragmatic approach was taken towards the management of the OVT given the haemorrhagic risk from her traumatic injuries. A multidisciplinary, consultant-led plan was made to slowly increase enoxaparin to a therapeutic dose under close surveillance and to then switch to warfarin following an outpatient consultation with a consultant haematologist. A MR venogram was performed after 3 months of anticoagulation, and this demonstrated complete resolution of the OVT and normal appearances of the ovary.
Collapse
Affiliation(s)
- Emma Toman
- Department of Neurotrauma, Surgical Reconstruction and Microbiological Research Centre, Birmingham, West Midlands, UK Department of Major Trauma Service, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK
| | - Alastair Beaven
- Department of Major Trauma Service, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands, UK Department of Major Trauma, Surgical Reconstruction and Microbiological Research Centre, Birmingham, West Midlands, UK
| | - Moji Balogun
- Department of Radiology, Birmingham Women's Hospital, Birmingham, West Midlands, UK
| | - Keith Porter
- Department of Major Trauma Service, University Hospitals Birmingham, Birmingham, West Midlands, UK
| |
Collapse
|
10
|
Ovarian Vein Thrombosis as a Complication of Laparoscopic Surgery. Case Rep Obstet Gynecol 2015; 2015:682941. [PMID: 26788386 PMCID: PMC4691616 DOI: 10.1155/2015/682941] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 11/25/2015] [Indexed: 11/22/2022] Open
Abstract
Ovarian vein thrombosis (OVT) is an extremely rare but life-threatening complication of the postpartum period. It has never been reported as a complication of laparoscopic surgery. We report a case of right ovarian vein thrombosis that occurred in the postoperative period after patient underwent laparoscopic salpingectomy for a right side ectopic pregnancy. She presented with 1-week history of abdominal pain and fever. A complete workup for fever was performed and was found negative. Computed tomography of the abdomen and pelvis revealed right ovarian vein thrombosis. The patient was treated with anticoagulant therapy and responded well.
Collapse
|
11
|
Khishfe BF, Sankovsky A, Nasr I. Idiopathic ovarian vein thrombosis: a rare cause of abdominal pain. Am J Emerg Med 2015; 34:935.e1-2. [PMID: 26475360 DOI: 10.1016/j.ajem.2015.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 09/06/2015] [Indexed: 02/03/2023] Open
Abstract
Ovarian vein thrombosis (OVT) is a rare but potentially serious condition that affects mostly postpartum women. It has also been associated with other conditions, such as pelvic inflammatory disease, malignancy, sepsis, inflammatory bowel disease, and recent pelvic or abdominal surgery. It is critical to recognize and treat this condition as early as possible to avoid the potential complications of the thrombosis and adverse sequelae such as infection and sepsis. We report a case of idiopathic OVT in a previously healthy premenopausal woman presenting with sudden onset groin pain. Nephrolithiasis was high on the differential, so a computed tomography abdomen/pelvis was done, which showed OVT. Patient was admitted to the gynecology service for intravenous antibiotics and for anticoagulation. Patient did well and was discharged after 2 days on Coumadin and oral antibiotics. Ovarian vein thrombosis is a rare condition with a number of serious and life-threatening complications. Therefore, not only is a high level of scrutiny required, but also an increased index of suspicion is essential for diagnosis of OVT and prevention of these dangerous outcomes.
Collapse
Affiliation(s)
- Basem F Khishfe
- Department of Emergency Medicine, Mt Sinai Hospital, Chicago, IL.
| | - Anna Sankovsky
- Rosalind Franklin University of Medicine and Science, North Chicago, IL
| | - Isam Nasr
- Department of Emergency Medicine, Cook County (Stroger) Hospital, Chicago, IL
| |
Collapse
|
12
|
Abstract
BACKGROUND Ovarian vein thrombosis is a rare diagnosis typically seen in the early peripartum period but also in other thrombophilic states such as postsurgery, pelvic inflammatory disease, malignancy, or sepsis. We describe a case of idiopathic ovarian vein thrombosis in a healthy woman far outside the peripartum window. CASE The patient is a 29-year-old woman, gravida 3 para 2102, with no significant surgical or medical history referred for 8 months of severe left lower quadrant pain. An ultrasonogram revealed a nonocclusive left ovarian vein thrombosis. Hypercoagulable workup and all other laboratory tests were normal. The thrombus resolved within 2 months of starting oral anticoagulation therapy. CONCLUSION This case demonstrates the importance of including idiopathic ovarian vein thrombosis in the differential diagnosis of nonperipartum females with pelvic pain.
Collapse
|
13
|
Roepke RML, de Campos FPF, Lovisolo SM, Santos EHS. Septic pelvic thrombophlebitis of unknown origin: an ever threatening entity. AUTOPSY AND CASE REPORTS 2014; 4:39-46. [PMID: 28573117 PMCID: PMC5444397 DOI: 10.4322/acr.2014.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 09/10/2014] [Indexed: 11/23/2022] Open
Abstract
Septic pelvic thrombophlebitis (SPT) is a rare and severe entity, which may occur after abortion, delivery, gynecological diseases, or surgeries. Diagnosis is challenging when no risk factor is clearly present, since clinically, symptoms are non-specific. Nowadays, with the aid of imaging methods, diagnosis has become more achievable, but the treatment still bears some uncertainties. The authors present a fatal case of SPT in a young woman who sought medical care already presenting signs of septic shock, referring fever and non-characteristic abdominal pain. The patient evolved rapidly to multiple organ failure and respiratory distress, which was also due to septic pulmonary embolism. The autopsy confirmed the computed tomographic findings of a right ovarian vein septic thrombophlebitis and multiple septic pulmonary embolization foci. The patient did not present any of the recognized risk factors; neither did she present signs of pelvic inflammatory disease on admission or at autopsy. However, an intrauterine device was present. The authors call attention to this entity in the differential diagnosis of a woman with fever and abdominal pain, as well as for an empiric broad-spectrum antibiotic regimen in these cases.
Collapse
Affiliation(s)
- Roberta Muriel Longo Roepke
- Department of Internal Medicine - Hospital das Clínicas - Faculdade de Medicina - Universidade de São Paulo, São Paulo/SP - Brazil
| | | | - Silvana Maria Lovisolo
- Anatomic Pathology Service - Hospital Universitário - Universidade de São Paulo, São Paulo/SP - Brazil
| | | |
Collapse
|
14
|
Sánchez Pascual M, Lobato Miguelez J, Larrazabal Echevarría E, López Valverde M. Trombosis venosa ovárica bilateral idiopática. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2013. [DOI: 10.1016/j.gine.2012.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
15
|
Harris K, Mehta S, Iskhakov E, Chalhoub M, Maniatis T, Forte F, Alkaied H. Ovarian vein thrombosis in the nonpregnant woman: an overlooked diagnosis. Ther Adv Hematol 2013; 3:325-8. [PMID: 23616918 DOI: 10.1177/2040620712450887] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Kassem Harris
- Staten Island University Hospital, Staten Island, NY, USA
| | | | | | | | | | | | | |
Collapse
|
16
|
De Stefano V, Martinelli I. Abdominal thromboses of splanchnic, renal and ovarian veins. Best Pract Res Clin Haematol 2012; 25:253-64. [PMID: 22959542 DOI: 10.1016/j.beha.2012.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Thromboses of abdominal veins outside the iliac-caval axis are rare but clinically relevant. Early deaths after splanchnic vein thrombosis occur in 5-30% of cases. Sequelae can be liver failure or bowel infarction after splanchnic vein thrombosis, renal insufficiency after renal vein thrombosis, ovarian infarction after ovarian vein thrombosis. Local cancer or infections are rare in Budd-Chiari syndrome, and common for other sites. Inherited thrombophilia is detected in 30-50% of patients. Myeloproliferative neoplasms are the main cause of splanchnic vein thrombosis: 20-50% of patients have an overt myeloproliferative neoplasm and/or carry the molecular marker JAK2 V617F. Renal vein thrombosis is closely related to nephrotic syndrome; finally, ovarian vein thrombosis can complicate puerperium. Heparin is used for acute treatment, sometimes in conjunction with systemic or local thrombolysis. Vitamin K-antagonists are recommended for 3-6 months, and long-term in patients with Budd-Chiari syndrome, unprovoked splanchnic vein thrombosis, or renal vein thrombosis with a permanent prothrombotic state such as nephrotic syndrome.
Collapse
Affiliation(s)
- Valerio De Stefano
- Institute of Hematology, Catholic University, Largo Gemelli, Rome, Italy.
| | | |
Collapse
|
17
|
Sharma P, Abdi S. Ovarian vein thrombosis. Clin Radiol 2012; 67:893-8. [PMID: 22464919 DOI: 10.1016/j.crad.2012.01.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2011] [Revised: 01/15/2012] [Accepted: 01/25/2012] [Indexed: 11/19/2022]
Abstract
Ovarian vein thrombosis is a well-known but rare entity, which can occur during the post-partum period. This condition has also been associated with inflammatory and malignant processes within the pelvis. Untreated, complications of ovarian vein thrombosis can be significant due to the associated sepsis and risk of pulmonary embolism. Diagnosis can be made with confidence using ultrasound, computed tomography or magnetic resonance imaging. Treatment of ovarian vein thrombosis is particularly important in the post-partum patients, with anticoagulation therapy being the current recommendation.
Collapse
Affiliation(s)
- P Sharma
- Department of Radiology, Royal Hallamshire Hospital, Sheffield, UK.
| | | |
Collapse
|
18
|
Stephan D, Gaertner S, Miréa C, Marescaux J, Aleil B. [Ovarian-vein thrombosis]. Presse Med 2011; 41:550-1. [PMID: 22104485 DOI: 10.1016/j.lpm.2011.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 07/27/2011] [Accepted: 07/29/2011] [Indexed: 11/29/2022] Open
Affiliation(s)
- Dominique Stephan
- CHRU de Strasbourg, hypertension, maladies vasculaires et pharmacologie clinique, BP 426, 67091 Strasbourg, France.
| | | | | | | | | |
Collapse
|
19
|
Current world literature. Curr Opin Support Palliat Care 2011; 5:174-83. [PMID: 21521986 DOI: 10.1097/spc.0b013e3283473351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|