Abstract
Heparin anticoagulation was evaluated in 46 postpartum, postabortal, or postoperative patients with septic pelvic thrombophlebitis. Criteria for diagnosis, in addition to the characteristic temperature course, were radiologic evidence of septic pulmonary emboli (15 cases) or persistence of spiking fever despite antibiotic therapy. Response to heparin plus antibiotics was good in all but four patients, three of whom were found at laparotomy to have associated septic complications requiring surgical treatment. The fourth had a severe anaerobic streptococcus and bacteroides septicemia and died despite treatment which included inferior vena cava ligation and hysterectomy. Heparinization appears to be a safe and effectual alternative to venous ligation in the management of septic thrombophlebitis of the pelvic veins.
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