Huge Trombus including Left Renal Vein, Ovarian Vein, and Inferior Vena Cava Mimicking Renal Colic.

Sakir Ongun,Funda Obuz,Abdullah Katgi,Aykut Kefi,Sermin Coban

doi:10.1155/2014/351270

Abstract

A 31-year-old female presented with acute left flank pain; she had a C/S at the postpartum day 24. Ureteral stone was suspected but ultrasound examination was normal. Then Doppler ultrasound revealed a trombus in left renal vein and inferior vena cava. Contrast enhanced MDCT scan showed swelled and nonfunctional left kidney, a trombus including distal part of left ovarian vein, left renal vein, and inferior vena cava. We started anticoagulation treatment. Further examination revealed diagnosis of chronic myeloproliferative disease. The trombus was completely recanalized at 3-month followup.

Highlights

We present an interesting case of a postpartum woman, who had a thrombus including distal part of left ovarian vein, left renal vein, and inferior vena cava
Ovarian vein thrombosis (OVT) is an uncommon complication in the early postpartum, cesarean delivery and increases the risk of thrombosis to 1-2% and multiparity has been identified as a risk factor for thrombosis in general [6, 7]
OVT may present with a broad range of symptoms, ranging from unresponsive fever to nonspecific back pain or right lower quadrant pain or may be entirely asymptomatic

Summary

Introduction

Ovarian vein thrombosis (OVT) is a rare and serious situation that affects mostly postpartum women, with a reported incidence of 0.02–0.20% of all pregnancies [1]. OVT occurs 80%–90% in the right side; this could be caused by compression of the right ovarian vein against the sacral promontory due to an enlarged dextroverted uterus and presence of retrograde flow in the left ovarian vein [2, 3]. The majority of cases remain misdiagnosed because of their nonspecific clinical presentation which can mimic pyelonephritis, ureteral obstruction, and acute abdomen [1, 5]. We present an interesting case of a postpartum woman, who had a thrombus including distal part of left ovarian vein, left renal vein, and inferior vena cava

Case Presentation

Findings

Discussion