Ovarian vein thrombosis

Ovarian vein thrombosis typically presents a complication in the postpartum period and is encountered most frequently after caesarean section. It is caused by venous stasis and hypercoagulability. The incidence of puerperal vein thrombosis (POVT) is approximately 1 in 2,000 deliveries [33]. Other conditions such as infection, recent surgery, malignancy, and Crohn disease increase the risk for ovarian vein thrombosis [34]. Although a rare entity, ovarian vein thrombosis presents a differential diagnostic problem because of the unspecific clinical symptoms, including fever, and the potential of fatal complications due to uterine necrosis... 

Color Doppler ultrasound is the primary imaging modality in patients with suspected ovarian vein thrombosis. Especially in the postpartal period, its performance is often limited due to uterine enlargement, postoperative changes, or obesity. This is why CT or MRI are commonly performed to rule out ovarian vein thrombosis. 

Fig. 17.12a,b. ovarian vein thrombosis. CT scans at the level below the renal hilum (a) and lower lumbar region (b). In a patient with bony metastasizing breast cancer (m), a nonoccluding thrombus (arrow) is identified within the dilated right ovarian vein (b). At the level just below the renal hilum, the renal vein (arrowhead) is patent (a)... 

Savader S, Otero RR, Savader BL (1988) Puerperal ovarian vein thrombosis evaluation with CT, US, and MR imaging. Radiology 167 637-639... 

Quane LK, Kidney DD, Cohen AJ (1998) Unusual causes of ovarian vein thrombosis as revealed by CT and sonography. AJR Am J Roentgenol 171 487-490... 

Kubik-Huch RA, Hebisch G, Huch R et al (1999) Role of duplex color Doppler ultrasound, computed tomography, and MR angiography in the diagnosis of septic puerperal ovarian vein thrombosis. Abdom Imaging 24 85-91... 

Resistance of activated protein C and deep calf vein thrombosis has been reported during controlled ovarian stimulation for in vitro fertilization (18). The thrombosis occurred on the eighth day of human menopausal gonadotropin use and before human chorionic gonadotropin was given. 

Ludwig M, Felberbaum RE, Diedrich K. Deep vein thrombosis during administration of HMG for ovarian stimulation. Arch Gynecol Obstet 2000 263(3) 139-41. 

Belaen B, Geerinckx K, Vergauwe P, Thys J. Internal jugular vein thrombosis after ovarian stimulation. Hum Reprod 2001 16(3) 510-2. 

Loret de Mola JR, Kiwi R, Austin C, Goldfarb JM. Subclavian deep vein thrombosis associated with the use of recombinant follicle-stimulating hormone (Gonal-F) complicating mild ovarian hyperstimulation syndrome. Fertil Steril 2000 73(6) 1253-6. 

Fig.8.3a-c. Balloon-occluded retrograde transvenous obliteration for duodenal varices, a A varicogram obtained by-injection of sclerosant through a microcatheter advanced into the pancreaticoduodenal vein shows duodenal varices (arrowheads). A balloon catheter is inserted into the right ovarian vein (flrrow).b A contrast-enhanced CT obtained before BRTO shows duodenal varices (arrow), c A contrast-enhanced CT obtained 7 days after B-RTO shows thrombosis of the duodenal varices... 

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