Laproscopic Investigation Of the Ovarian Vein Thrombosis: An Uncommon Complication

Description: Thrombosis of The Ovarian Vein is an uncommon event in a postpartum period. It takes place in 0.05% up to 0.18% of all gravidances and is placed on the right side in 80-90% of patients. Case description: A 32-year old lady came to ER complaining of fever, acute pain of the abdomen and distention of the abdominal wall. Right lower quadrant resulted more sensitive in the physical examination. Radiography revealed fecal stasis and the ultrasound examination showed interintestinal fluid gathering in a Dougls pouch. We diagnosed an accute appendix inflammation. Exploring laparoscopy was done and thrombosis of the right ovarian vein was observed. ES indicated the same disease. Anticoagulation medicines together with antibiotics were started immediately and the CT-image showed thrombosis even in the cava. On POD4 patient went home. One month after the procedure the woman was in a good state, without any evidence of the disease. Conclusion: It is hard to make a diagnosis of thrombosis of the ovarian vein due to rarity of the disease. Proper disorder identification is necessary, as well as immediate treatment. A CT, MRI and ultrasound can help to recognize the thrombosis. Ovarian vein thrombosis should be suspected in every women after the gravidancy, which is suffering from pain of the lower abdomen, fever and high leukocytes level. Authors: Giancarlo Basili, MD, Nicola Romano, MD, Luca Lorenzetti, MD, Valerio Prosperi, MD, Orlando Goletti, MD